Positive Options for Living with Lupus Read Online Free PDF Page B

people are the ones most likely to be taking medication for conditions other than lupus.
    This introduces a group of people who, independent of age and sex, develop lupus as a consequence of taking certain drugs, a variation known as “drug-induced lupus.” These are probably the only cases where the cause is emphatically certain and the cure obvious. The POL text Q6 good.qxp 8/12/2006 7:39 PM Page 21
    W h o D e ve l o p s L u p u s , W h e re , a n d W hy ?
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    drug causing the problem must be stopped or changed. Drug-induced lupus is considered in more detail in Chapter 9.
    Lupus in History
    The name “lupus” for a skin disease has been around for more than seven centuries.
    Thirteenth century. The Italian physician Rogerius describes a disease characterized by lesions and calls it “lupus.” In medieval Latin the word for “wolf”— lupus —was also used to mean “ulcerated,”
    perhaps because sores or ulcers that eat into the face look rather like a wolf bite.
    Seventeenth century. Philosopher/physicians Paracelsus and Sen-nert provide clear descriptions of “lupus” skin lesions.
    1828. French dermatologist Laurent-Théodore Biett identifies three types of lupus and coins the term “lupus erythemadoides” for the distinctive butterfly rash. His teachings are published by his pupil Pierre Cazenave in Practical Summary of Skin Diseases .
    1873. Moritz Kaposi, professor of dermatology at the medical school at the University of Vienna, Austria, publishes a series of articles on lupus erythematosus, noting that patients with the rash also have other symptoms—in other words, that it is systemic. He writes, “Lupus erythematosus . . . may be attended by altogether more severe pathological changes . . . and even dangerous constitutional symptoms may be intimately associated with the process in question, and that death may result from conditions which must be considered to arise from the local malady.”
    1890. Thomas Payne, a physician at St. Thomas’ Hospital, London, is the first to recognize that antimalarial drugs, long used to treat fever, may have more general healing powers for symptoms like joint pain and fatigue in lupus.
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    Po s i t i v e O pt i o n s fo r L i v i n g w i t h L u p u s 1895–1903. In a series of papers, the celebrated U.S. physician William Osler describes other organs involved in lupus—heart, kidneys, and other “mucous surfaces”—and defines the condition as both systemic and chronic (relapsing and remitting).
    1941. On the basis of numerous postmortem studies of damaged organs in lupus patients, Paul Klemperer, at the Mt. Sinai Hospital, New York, proposes that lupus is a “collagen vascular” disease. This term remains in use for fifty years or more.
    1948. The diagnosis of lupus moves into a new phase: Malcolm Hargraves, of the Mayo Clinic, in Rochester, Minnesota, identifies an odd-looking white blood cell, first in the bone marrow, then in the blood of people with acute lupus. It becomes known as the LE
    (lupus erythematosus) cell. As a result, the first blood test for lupus is devised and the number of people diagnosed rises steadily.
    1954–1972. Several other anomalies are detected in the blood of people with lupus. Chief among these is an antibody that works specifically against the body’s own DNA (deoxyribonucleic acid—
    the genetic raw material of living systems). A test for this antinuclear antibody—ANA—replaces the LE as the gold standard for detecting lupus, and lupus becomes located firmly in the family of autoimmune diseases. (Details of these sophisticated diagnostic tests are included in Chapter 4.)
    1983. A group led by Graham Hughes, at St. Thomas’ Hospital, identifies the antibody associated with the artery and vein thrombosis, strokes, and miscarriages that had made pregnancy so risky for lupus sufferers. The condition for which this antibody is the culprit is renamed Hughes’ syndrome.