Systemic Lupus Erythematosus: A Few Things
By Groshan Fabiola
The systemic lupus erythematosus can occur in either sex, at any age, but it is known that lupus affects more women than men. It is 10 to 15 times more frequently among adult females than among adult men, and that is why sometimes, systemic lupus erythematosus is called a woman’s disease.
Studies revealed that before puberty, there is about one male affected for every three females, and in the adult years, this ratio changes: 10 females are affected for every male.
Also, after menopause, the studies show that there are 8 females for every male affected.
There are some medications that can produce the drug-induced lupus. This lupus appears more often in men, because these drugs are more frequently used in men. We can mention here procainamide, which is used to treat different types of heart abnormalities, and hydralazine which is used to control high blood pressure.
Seems that the symptoms of the systemic lupus erythematosus are the same in men and women too, at least at the beginning of the disease. There are studies that reached the conclusion that there is more severe renal, neurologic, and vascular disease in men with systemic lupus erythematosus than in woman. But, more research needs to be done in that direction, so, at this time, there isn’t enough evidence to sustain there are more severe symptoms in men than in women.
For years, there were made studies that involved the estrogens- female hormones- and the androgens( male hormones). There was seen there is a difference in the way that androgens are metabolized by male and female lupus patients. There also is the suspicion that women with lupus metabolize androgens at a faster rate than women without lupus.
It is known that lower testosterone levels may predispose men to autoimmune-like diseases. There are drugs that lower testosterone levels, and are associated with rheumatic symptoms, but have not been specifically associated with the onset of systemic lupus erythematosus.
Because the systemic lupus erythematosus is sometimes called a woman’s disease, there can appear the misconception that men who have lupus are less masculine. That fact is not true, it was proved that men with lupus are fertile, sexually active and potent, and some of them are very hairy too. Men with lupus are not different hormonally than the others that don’t have this disease.
Sometimes, having lupus can be a situation pretty difficult to cope with. Men affected by this disease may no longer be able to perform or progress in their work environment, or they may not be able to work anymore and support a family. The cultural and societal expectations of men put him in a difficult situation. This fact, the inability of work and earn a living can cause serious emotional and mental stress for him.
In what concerns women, it doesn’t always happen in the same way. Women which have lupus are more affected by the symptoms that appear, like rashes, hair loss, and weight gain.
It is known there are lupus support groups, and it is a logical thing there are more women in these groups, because lupus affects mostly women. It is important that men affected by lupus try and integrate in that groups, because in this way, they will get help for moving forward.
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By Robin_Brain
Basic Description
Lupus is a chronic disease in which the immune system attacksthe connective tisue of joints, muscles, and skin as well as the membranes surrounding other body organs. People with lupus are often constantly tired and especially sensitive to sunlight On the other hand, the rashes and joint pain that also characterize the disorder are episodic-one day symptoms are present, the next day they are not.
The exact causes of lupus are unknown, though heredity is believed to playa role in determining risk. African Americans are three times as likely as Caucasian Americans to develop the condition. The vast majority of lupus victims are women, and the condition most often strikes between the ages of 15 and 35.
Signs and Symptoms
Severe joint pains and joint swelling
Rash across the nose and cheeks
Sensitivity to sunlight
Weakness and fatigue
Weight loss
Ulcers of the mouth or throat
Mental confusion
Anemia
Kidney dysfunction
Conventional Medical Treatment
If you have symptoms of lupus, see your physician, who can diagnose the condition with a blood test. For many lupus victims, the only treatment necessary is avoidance of excessive sunlight and constant use of a strong sunscreen lotion. In most cases the disease is not considered serious, and approximately 40 percent of victims experience a spontaneous-and total-remission.
Mild cases of lupus may only require the use of aspirin to relieve symptoms. In serious cases, lupus can lead to inflammation around the heart and lungs, kidney disease, or serious joint damage. If you suffer from a severe case of lupus, your physician may place you oncorticosteroids to limit joint inflammation. You also must undergo checkups on a monthly basis so that you can treat any of the above complications as they arise.
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Lupus in Pregnant Women
By Groshan Fabiola
Lupus is an affection which usually affects women and often it has been said that women who suffer from lupus cannot become pregnant due to their condition. Much more, specialists deny this affirmation, 50% of all women with lupus who become pregnant can have a normal pregnancy and deliver healthy babies. On the other hand, some women may face complications and lose their babies in the early stages of pregnancy.
Furthermore, even though many lupus pregnancies are totally normal, women risk to face problems during the period of their pregnancy. Pregnant women with lupus should be supervised by an obstetrician until the pregnancy ends and in this case the risk of the mother's health is diminished and normal babies can be borne. Moreover, women who suffer from lupus should follow the physician's instructions, they have to adopt a special diet and lifestyle and not in the last place, delivery must take place in a hospital.
First of all, even though, women in remission tend to have less trouble than women with active lupus, a good, healthy diet might help a lot during the pregnancy. So, some of the golden rules that a pregnant woman with lupus should follow are: proper medication, regularly visits at the doctor, an healthy food diet, no bad habits like smoking or drinking and also they should avoid pills that might put in danger the life of the baby.
Secondly, pregnant women may face certain symptoms such as lupus flare, rashes which ca appear due to an increased blood flow in the skin, new hair growth during pregnancy and also severe loss of hair after delivery. What is more is that 20% of lupus patients tend to have a sudden increase in blood pressure, protein in the urine, affections which are known as toxemia and require a serious treatment and even immediate delivery. Another serious complications that may occur to lupus pregnancies are the presence of antibodies which interfere with the function of the placenta. So, these antibodies also known as antiphospholipid usually cause blood clots, including blood clots in the placenta, exposing the placenta to high risks. it is important to mention that many lupus patients have an antibody known as anti-ro or anti-SSA which may affect the unborn babies and exposing them to a syndrome known as neonatal lupus. Moreover, in many cases women who suffer from a severe form of lupus have to pass through a caesarian section in order to save he premature baby.
Taking all these into consideration, pregnant women who suffer from lupus can have a normal pregnancy if they follow an appropriate treatment and have a balanced lifestyle. Furthermore, it has been considered that most medications taken by SLE are safe to use during the pregnancy due to the fact that they don t get through the placenta and in this way the baby is not in danger. Moreover, these medications might help the unborn baby to mature and also they are used in order to fight against complications such as toxemia of pregnancy.
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What Is Lupus Erythematosus
By Tina Magtalas
Lupus Erythematosus LE (pronounced: er-uh-thee-muh-toe-sus)
was given its name by a 19th century French doctor who thought that the facial
rash of some people with lupus looked like the bite or scratch of a wolf ("lupus" are
Latin for wolf and "erythematosus" is Latin for red).
Lupus Erythematosus were first recognized as a disorder of the skin. The name
was given to differentiate this disorder from the skin changes found when
tuberculosis affects the skin. The severity of the systemic disorder appears to be
inversely related to the severity of the skin disorder.
Lupus are an unpredictable disease. Signs of the disease appear and disappear,
sometimes for no apparent reason. Because lupus assume so many different forms
and can change, finding the right balance of treatment for you may take time. Your
treatment will depend on the symptoms you experience and the organs affected.
Once an effective treatment program has been started, continue to follow it. If your
symptoms change, let your doctor know so that you can work together to modify
your program.
People who may have Lupus also experience symptoms such as: Fatigue along
with dizziness, headaches or depression, unexplained fever, which may be an early
sign of lupus
Even though the cause of lupus is unknown, researchers think that many factors may trigger the disease. Genetics may play a role. Some people may have a genetic predisposition to
lupus that is then activated by an infection, certain medications, or extreme
physical or emotional stress. The hormone estrogen may also play a role in
lupus and could help explain why it is more common in females than males.
Lupus also occur more frequently in African Americans, Asian Americans,
Latinos, and Native Americans than in Caucasians.
Lupus can affect almost any part of your body, including your joints, skin,
kidneys, heart, lungs, blood vessels, and brain. There is no way to know what
part of your body will be affected. For most people though, lupus are a mild
disease affecting only a few parts of your body, and some patients don't get
inner organ problems (like in the heart and lungs), but do have skin and joint
problems.
A blood test called an ANA, which detects a group of autoantibodies found in the blood of
people with lupus. These autoantibodies attack the body’s own cells. However,
this test is not diagnostic of lupus. Other laboratory tests to detect specific
antibodies such as anti-DNA or an anti. An a SM may be helpful in diagnosing
lupus or related diseases.
The Treatment plan for lupus includes taking medications to reduce the
inflammation and reduce the activity of the immune system, balancing rest with
exercise, and maintaining a proper diet.
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Lupus Erythematosus - Skin Disorders
By Robin Kumar Lim
Hyperthyroidism.
Autoimmune thyroid disease of the hypermetabolic type (
Diabetes Mellitus
Patients with diabetes mellitus may develop a number of cutaneous changes. The yellow plaques of necrobiosis lipoidica diabeticorum most often located on the anterior shins, are the most distinctive of these changes.Small, hypopigmented, slightly depressed scars (diabetic dermopathy) are also occasionally found on the anterior lower legs. These lesions probably represent obliterative small vessel disease in an area prone to trauma. Bullous lesions somewhat similar in appearance to those of pemphigoid may arise from otherwise normal-appearing skin around the feet and ankles. The cause of these blisters is unknown. Eruptive xanthomas consisting of small, smooth, pink, dome-shaped papules may appear in a sudden shower of lesions in those whose diabetes is grossly out of control. Staphylococcal bacterial infections and candidal yeast infections are seen with increased frequency in diabetic persons. Diabetes is also associated with a variety of other cutaneous and medical conditions.
Neurofibromatosis
The presence of sharply marginated, light brown patches (cafe-au-lait patches) is often the first clue to the presence of von Recklinghausen's disease . In late childhood or during the teenage years, axillary freckling and cutaneous neurofibromas begin to develop. The latter are soft, smooth-surfaced, peduncuated papules 0.5 to 2 cm in diameter. They vary in number from several to hundreds and are distributed randomly over the trunk and extremities. Patients with the most severe forms of neurofibromatosis may develop large, grotesque, sack-like plexiform neuromas. A small proportion of these latter lesions undergo sarcomatous degeneration.
Tuberous Sclerosis
The earliest sign of tuberous sclerosis is generally the presence of small, faint white, oval patches (ash leaf spots) scattered randomly on the trunk and extremities . These lesions may be present at birth or may develop in early childhood. One or more thickened skin-colored plaques (shagreen plaques) may appear on the lower back in late childhood. Towards puberty, pinhead-sized, smooth, red, dome-shaped papules (adenoma sebaceum) begin to emerge on the central portion of the face. The upper lip is spared. Such lesions are easily mistaken for acne papules. Finally, in adult life, small, firm, skin-colored, subungual or periungual fibromas may be noted.
Peutz-Jeghers Syndrome.
This dominantly inherited condition is characterized by the presence of small brown or blackfreckles that appear in clusters on and around the lips and on the fingertips. These pigmentary changes are accompanied by the development of intestinal polyps. Carcinomatous degeneration of these polyps is not common but does occur.
Osler-Weber-Reudu Syndrome
This dominantly inherited condition, also known as hereditary hemorrhagic telangiectasia, is characterized by the presence of small, dusky red, clustered manlles on the fingertips, lips, and mucosal surfaces. These macules are composed of multiple telangiectatic vessels that blanch on pressure. Lesions similar to these may also .occur in patients with the CRST (calcification, Raynaud's phenomenon, scleroderma, and telangiectasia) variant of scleroderma. Patients with this disease have recurrent episodes of epistaxis and gastrointestinal bleeding. Arteriovenous fistulae are sometimes present in the lungs and liver.
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The Three Types Of Lupus
By Groshan Fabiola
Lupus is a rare condition, but it can be a very difficult one. When you suffer from lupus, more than one of your organs may be affected. There are three lupus types that one can suffer from: systemic, discoid and lupus induced by drugs.
The discoid form of lupus affects only somebody' s skin. To diagnose this kind of lupus, the doctor has to do a biopsy of the rash that you are suffering. Because discoid lupus affects only the skin in form of a rash, this is the only proper way to diagnose lupus. The biopsy of the skin affected by lupus will show some abnormalities that otherwise will not be found in a type of skin that has not been affected by lupus. This type of lupus does not affect the internal organs. So a blood test will not be able to confirm if you have discoid lupus or not. Blood tests are used to detect another lupus type, the systematic lupus. There are lupus patients that will show a positive result in their blood test, even if they are suffering from discoid lupus. However, the levels of tiver in their blood will be very little. Although the discoid form of lupus only affects your skin, this lupus type can evolve and become the systemic type of lupus. This particular lupus type can affects almost all your internal organs. Systemic lupus can also atack your nervous system. Unfortunately, this change from discoid lupus to systemic lupus can not be prevented. Even if your treat your discoid type of lupus, you can to prevent it from developing into the systemic lupus type.
Many of the people that go on to have systemic lupus, probably suffered from this form of lupus from the beginning, and the discoid lupus was just one of the symptoms. Normally, there are not two people that suffer from systemic lupus and have the same symptoms. However, many of the lupus symptoms that they have can be similar. The third type of lupus, that induced by drugs, usually sets off after you use a certain drug. The signs of the drug induced type of lupus are very similar to the systemic lupus type. The drugs that are more related with lupus are those used for high blood pressure. Drugs that are used to treat an irregular heart beat are also thought to cause lupus.
For more resources about lupus please review this http://www.lupus-guide.com/lupus-rash.htm or even http://www.lupus-guide.com/symptoms-of-lupus.htm
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THE HISTORY OF LUPUS ERYTHEMATOSUS
X. SIERRA, M.D. (TERRASSA,
Lupus erythematosus (LE) is a disorder which presents a wide and varied symptomatology. Its causes are also diverse and still little known. Finally, its evolution is so variable that it can range from a fatal outcome to a hardly apparent minor complaint, which would go on unnoticed were it not for the immuno-assay tests available to us today.
When the injuries of lupus erythematosus are limited to the skin it is known as discoidal lupus erythematosus. When, on the other hand, there exist visceral effects, it is known as systemic lupus erythematosus. The developement of knowledge about lupus erythematosus has been reviewed by some authors 1,2.
THE ORIGIN OF THE NAME "LUPUS"
The name by which this disease is known alludes to the wolf -lupus in Latin- because of the destructive injuries that can bring to mind the bites of this animal. It is possible that in the beginning the name did not refer to a particular disease, but rather to any ulcerated injury with the destruction of tissue3. Although this name has been attributed to Paracelsus (1493-1541), Giovanni Manardi (1462-1536) had previously referred to some ulcers on the leg, which destroyed the surrounding area, using the comparison with a bite of hungry wolf.
Paracelsus, somewhat younger than Manardi, may have taken this graphic denomination from him, since he (Paracelsus) frequently speaks about lupus, fluently and as if dealing with something already known which did not need further explanation. As far as he was concerned, lupus was a cutaneous injury that "devoured" the excess blood, for which reason he suggested treating it with bleeding.
Rudolf Virchow's keen historical curiosity led him to make a great effort towards establishing the origin of the term and to investigate ancient sources4. According to his conclusions it might have been a popular term used in the Middle Ages, and, having caught on, later became more generalized and entered the language of Medicine, thereby preceding Manardi and Paracelsus and their usage. One of the texts that he found, attributed to the German Johann Tollat von Vorchenberg, written at the beginning of the 15th century, said textually:
"...for the wolf and for cancer, caprifolin..."
Another text referred to by Rudolf Virchow (1821-1902) is older still. It dates back to the end of the 13th century and is a treatise on surgery by Roger de Palma, of the
"Sometimes lupus arises in the thighs and the lower legs (and is) distinguished from cancer from the symptoms mentioned above".5
Nevertheless, no passage has been found that reveals the distinction between lupus and cancer. What is clear, however, is that from Roger to Manardi, lupus is spoken of as a typical complaint affecting the lower extremities. So, in those times, the term lupus would not refer, as it would later, to a disease of the nose and face. As Virchow already stated, this denomination was applied in a very diverse and vague way in the Middle Ages. It was Virchow himself who showed that Hans von Gersdorf was one of the first medical writers that referred to a facial disorder using the word lupus:
"Leprosy is more clearly recognized in the nose, where it shows well-defined symptoms. Sometimes it is also called wolf because it can contaminate all of a man's limbs as does cancerous lupus"6
In short, the prevailing idea up to the end of the 16th century, inherited from the
However, there are indications that what we know today as lupus erythematosus was a disease that also existed in antiquity, even before the discovery of America7. According to conclusions reached after paleo-pathologic studies, a young female pre-columbian mummy of the Huari culture, seems to represent "one of the earliest cases of collagen disease, with many aspects compatible with SLE"8.
LUPUS AT THE BEGINNING OF SCIENTIFIC DERMATOLOGY
Robert Willan (1757-1812), in 1808, had used the word lupus to describe cutaneous tuberculosis, especially when this was located on the face. Even today, we use lupus vulgaris for some forms of tuberculosis of the skin. Considered the founder of British dermatology, Robert Willan, in his book published in 1808, reserves the denomination lupus for a nodular eruption on the face which develops into an ulceration. From this moment onwards, this disorder would be known as lupus Willani, even though it is unlikely that either Willan or his faithful assistant Thomas Bateman (1778-1821) had a very clear conception of this disease9.
In 1851, Pierre Louis Alphée Cazenave (1795-1877) made a substantial contribution to the study of lupus erythematosus. Some years earlier, his teacher Biett, had identified an especial variety within the erythema genus, the centrifugal erythema; and the variety of lupus that destroys on the surface. In his text, Cazenave considers both to be varieties of lupus which in 1851 he named lupus erythematosus and of which he left us this unforgettable description:
"In some circumstances (lupus) manifests itself at first as a violet rubefaction on this or that part of the face, and mainly on the nose, which at the same time is rather swollen: over many months the colour rises little by little; the surface becomes animated; a small ulcer forms and on top of it, a scab, which then thickens and covers the ulcer, which becomes progressively deeper. Lastly, the skin may get thinner in imperceptible stages and adopt the appearence of a scar, without there being tubercles or ulcers, and without displaying worse injuries than a livid colour and, from time to time, a light and barely perceptible peeling"10.
Cazenave in his book "Abregé pratique des maladies de la peau" faithfully adhered to the classification that Biett had proposed11. However he introduced some new orders of diseases. Amongst them were lupus. After a few years, Ferdinand von Hebra (1816-1880) accepted the existence of the illness under the name lupus erithematosus 12,13.
DISCOIDAL LUPUS AND DISSEMINATED LUPUS
Moriz Kaposi (1837-1902) also concerned himself with the origin of the word lupus and included the findings of Ferdinand von Hebra in his book, quoting Johannes Soleus, who used the term about 1710 to describe an ulcer that corroded the nose14. The denomination discoidal lupus to describe the forms of exclusively cutaneous injury is credited to the
The frequency of tuberculosis at that time was considerable. In the same five years when Kaposi diagnosed 22 cases of DLE, 279 cases of lupus vulgaris were seen in the same department16. One of his female patients with discoidal lupus erythematosus died displaying pulmonary tuberculosis. In spite of the extraordinary frequency of tuberculosis at that time, and that lupus and cutaneous tuberculosis were then considered related affections, Kaposi maintained that discoidal lupus erythematosus had no relation whatsoever to tuberculosis. Not everyone supported this opinion, and it met with special resistence amongst French dermatologists, and was disputed until beyond the first third of the 20th century. Kaposi used the term disseminated lupus erythematosus to refer to those cases in which there are dispersed cutaneous injuries, rather than those which exhibit visceral affection. However, he described some cases which involved fever, pleuritis, arthralgias and arthritis.
VISCERAL AFFECTION
It was not easy to come to the conclusion that lupus erythematosus, a disease regarded then as being exclusively dermatologic, could cause visceral injuries. At first, it was generally thought that when a lupus patient displayed these irregularities that a simple coincidence was the explanation17.
William Osler (1849-1919), from 1894 to 1903, observed 29 patients who presented "erythema with visceral injuries". It is generally accepted that many of these cases corresponded to descriptions of lupus erythematosus, although it is likely that revising them under present criteria, not all Osler's cases could be labelled in this way. At any rate, it was Osler who first indicated a renal affection or one affecting the central nervous system in cases of lupus erythematosus18,19.
A little later, in 1908, Alfred Kraus and Carl Bohac described the possible pulmonary affection of the syndrome: lupic pneumonia20. From then onwards other new visceral manifestations were described and this completed the clinical description of disseminated lupus erythematosus. In 1923, Emanuel Libman (1872-1946) and Benjamin Sacks contributed four cases of non-infectious endocarditis. Three of them displayed cutaneous injuries of LE21. The skin alterations were lacking in some cases, which caused the authors to hesitate in ascribing endocarditis to the LE table. In those times the greater part of studies of LE had been carried out by dermatologists, and perhaps for this reason the existence of cutaneous affection was considered essential for the diagnosis of lupus. Some years later, in 1936, George Belote and H.S. Ratner ratified that the endocarditis of Libman-Sacks was a manifestation of LE, even without the skin injuries22. A little later, in 1939, leukopenia and hypersensitivity to sunlight were described in cases of LE.
Discoidal lupus erythematosus and systemic lupus erythematosus for a long time were considered different diseases with nothing in common. The idea that they were forms of the same disease, and that they could even present transitional forms was introduced in 1937 by Harry Keil, although it must be said that quite a long time passed before this idea gained a general acceptance. It was also Keil who clearly outlined the differential diagnosis of cutaneous manifestations in order to distinguish between lupus erythematosus and dermatomyositis23.
For a long time lupus was considered a strange entity of very low incidence. Thus, only eight cases were diagnosed between 1897 and 1908 in the University-Hospital of
LABORATORY DIAGNOSIS
However, the absence of complementary laboratory tests, which would have allowed the confirmation of the diagnosis, represented a serious difficulty in the identification of cases of LE. In 1948, a haematologist of the Mayo Clinic, Malcolm Hargraves, discovered a cell which, as he said:
"has been called an LE cell in our laboratory because of its frequent appearance in the bone marrow in cases of acute disseminated LE"26.
In the following years, the techniques for the demonstration of the LE cell were subjected to various modifications. They were simplified and made more accessible as a diagnostic method and went a long way towards making the detection of LE cases more reliable and certain.
In 1954 it was discovered that LE cells formed as a consequence of the existence of a serous factor and the leucocytic nucleus. In 1958, Friou was able to develop a laboratory test which made it possible to quantify the antigen-antibody reaction by using fluorescent antihuman globulin. The determination of antinuclear antibodies (ANA) gradually established itself as the principal diagnostic test for SLE and also made possible the evaluation of the severity of the disease. However, this development was not entirely beneficial. It was soon discovered that there could be false positive indications, in other words, positive reactions in persons not having SLE. The false positive indications could be caused by various circumstances, such as other diseases of the connective tissue, or treatment with certain drugs. Also, in
LUPUS ERYTHEMATOSUS BY DRUGS
In 1954 in the Cleveland Clinic, some cases of SLE in patients under treatment for hypertension with hydralazine were described. The diagnosis could be confirmed through the detection of ANA. Soon, cases activated by an antiarrythmic, procaine, were described. Since then, other medicaments have shown themselves capable of inducing injuries of SLE, such as penicillin, sulfonamide, isoniacide or contraceptives27.
DIAGNOSTIC CRITERIA
The clinical complexity of the laboratory tests on LE made the establishing of criteria for the diagnosis of SLE essential. With this aim, a commitee of North American rheumatologists met in 1971 and published a clinical and analytical scheme for the diagnosis of this disease. This standard, partly modified in 1982 is still in force in most countries28,29.
TREATMENT
As regards treatment, expectations were low until the appearance of corticosteroids. The real history of the corticoidal hormones began with the research of the Pole, Thaddeus Reichtein, at the University of Basle, and the North American Edward C. Kendall (1886-1972) of the Mayo Clinic, who separately but simultaneously discovered cortisone by isolating it from other integrant substances of the cortex of the suprarenal gland, at the same time establishing its chemical structure.
Some years before, in 1929, Philip S. Hench (1896-1965) had already observed that some arthritic patients could experience a temporary remission of their symptoms during pregnancy or coinciding with jaundice. Hench attributed this phenomenom to the existence of an adrenocortical hormone. Hench, like
Soon a derivative of cortisone, prednisone, synthesized in 1955, became the most common treatment for SLE31. Only some cases of renal and cutaneous affection resisted this treatment.
Discoidal LE also benefited from treatment with topical corticosteroids. In 1952 Sulzberger and
Treatment with antimalarials began in 1951 with quinacrine, which was administered in cases of discoidal lupus erythematosus33. A little later, other antimalarials were used, such as chloroquine and hydroxichloroquine, which are not only useful on cutaneous forms but also have applications in certain cases of SLE.
In the treatment of lupus immunosupressive drugs have played an important part. The first of these was nitrogenous mustard, tried out for the first time in 1952. Subsequently azatioprine and ciclofosfamide were introduced34, whose main indication are cases of serious renal affection resistent to corticotherapy.
With this therapeutic potential (to which we should add the possibility of treating potentially fatal bacterial infections with increasingly effective antibiotics) the mortality rate from LE has substantially decreased. At present, the survival rate 15 years after diagnosis has reached an average of 75% of all cases, although there are differences to consider regarding sex, age and race35. It is to be hoped that current research improves still further the diagnostic and therapeutic prospects of this disease in the near future.
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