Lupus is an autoimmune disease where the body’s immune system is hyperactive and attacks healthy cells and tissues. It is a disease of flares and remission. This means that you become ill when your symptoms worsen, and you feel better when your symptoms improve. Because lupus can affect many organs, the symptoms of lupus vary greatly from person to person. A friend of mine was recently diagnosed with lupus.
Nearly three years ago, Liz began experiencing loss of appetite and body aches. Her doctor told her that she was “overworking” her body, and that the symptoms were caused by stress. The doctor prescribed painkillers to relieve the aches. Every couple of months, Liz would experience the same symptoms. Over the course of two years, her symptoms became worse and worse. Various doctors told her that her cough, swollen lymph nodes, aches, and loss of appetite were due to stress. She took the medications doctors prescribed and reduced stressful activities in her life; however, her condition did not improve.
In January of 2010, Liz reached her breaking point. Her lymph nodes had been swollen for six months; her parents often found her asleep in the bathroom; and she experienced extreme fatigue and tremor. The results from her initial examination at St. Joseph’s hospital showed blood clots, swollen lymph nodes, and 70% edema. She experienced respiratory failure and was immediately hospitalize. Doctors initially thought it was leukemia. Further examinations lead doctors to believe she had lupus. “They told me I had lung disease one day and leukemia the next; they told my parents that I would need a blood transfusion one day and a bone marrow transplant the next. But really, they didn’t know what was happening to me. That was the scariest part,” said Liz. Her lupus imitated symptoms of a blood disorder, lung disease, and leukemia.
During her hospitalization at St. Joseph’s, Liz was put into a medically-induced coma and was unconscious for three weeks. Doctors treated her with various drugs including anti-inflamatories, corticosteroids, and antibiotics. She developed C. diff and diabetes during her treatment. She was also on life support for two months. Liz was later transferred to another hospital for recovery. Doctors estimated six months of rehab for Liz. However, she learned to walk and talk within two months.
What is it like to live with lupus? “It sucks!” Liz exclaimed. “You really have to learn your body. Currently, I’m taking 20 pills a day, including prenatal and chemotherapy drugs. I take Ambien every night to go to sleep.” Doctors recommended a healthy diet and advised Liz not to work with children. Liz responded, “I want to live a normal life. I can’t live a normal life without my steak and junk food, and I definitely can’t live a normal life without my job.” Liz has her lupus under control and continues to live a normal life - with precautions of course.
I would like to first start off saying I am really sorry for your friend and I wish her the best quality of life. I have been in the same position as you in that I have known someone who suffered from lupus. I did not have intimate contact with this person, so I did not get a chance to hear how they were diagnosed and their symptoms. However, I do remember this person telling me it was painful. When I was reading the quote about your friend, I was curious why having a burger would be a bad decision, so I did some research.
ReplyDeleteThis website says that “poor dietary choices can generate pro- and anti-inflammatory effects” (1). “Saturated fats found in fatty beef are more pro-inflammatory than certain polyunsaturated fatty acids, such as EPA and DHA, which are found in fish oil” (1). This information is also important for people who suffer from arthritis and diabetes.
I also researched foods that fight inflammation. Salmon contains omega-3s which are anti-inflammatory fats (2). Grass-fed beef also contains omega-3s (2). Olive oil contains oleic acid, which is also anti-inflammatory (2). Salads which contain veggies are rich in vitamin C and other antioxidants that dampen inflammation (2). Again, these foods are important for individuals who suffer from joint pain.
References:
1.http://lupus.about.com/od/livingwithlupus/a/LupDiet.htm
2.http://www.dlife.com/dlife_media/diabetes_slideshows/anti-inflammatory-foods?index=10
Thanks for the post, it was really interesting, and definitely opened my eyes on this disease. I was shocked to see that your friend takes about 20 pills a day, but it got me thinking..what type of drugs do lupus patients take?
ReplyDeleteAs you stated, lupus is an autoimmune disease, and as a result of healthy cells being attacked, it leads to severe and/or long lasting inflammation. The main drugs prescribed are therefore anti-inflammatory drugs (1). I even found many sites that said acetaminophen was very widely used, but mostly for less severe forms of the disease.
Because of the improperly functioning immune system, often times corticosteroids are prescribed, which help suppress the immune system(1). As you could imagine, this would drastically increase the risk of infection(2).
It was difficult to find the mechanism by which lupus acts, because there is no one specific cause. But I did find a paper that singled out the protein CD154 which is overexpressed in T cells, but is expressed in B cells of patients with Systemic Lupus Erythematosus. B cells secrete autoantibodies that potentiate the inflammatory response, and they explained that CD154 was central to this process. Although little is still known about the exact mechanism of CD154, using an anti-CD154 treatment led to a slower progression of the disease, and inhibition of T cell activation.
Research is definitely progressing, and I am sure one day your friend will be able to live a normal life, without many of the precautions.
References:
(1) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001471/
(2) http://www.mayoclinic.com/health/lupus/DS00115/DSECTION=treatments-and-drugs
(3) http://www.ncbi.nlm.nih.gov/pubmed/22110533
I was reading some things about CD154 and ran across some other research about two possible mechanisms of lupus and how researchers are trying to reverse the effects of these mechanisms.
ReplyDeleteThe first possible mechanism involves the secretion of PPAR-delta in macrophages. Macrophages are white blood cells that digest cellular debris from dying cells and pathogens. The researchers had genetically engineered mice that did not have the PPAR-delta gene in their macrophages and injected the mice with apoptotic cells. The macrophages did not react to the dying cells and an autoimmune kidney disease arose. It is thought that PPAR-delta is directly involved in suppressing autoantibody production so that the macrophages do not carry out the digestion of healthy tissue.
Another proposed mechanism for lupus is a mutation in the gene encoding a protein called DNase1. DNase 1 normally removes garbage DNA and other cellular debris. The researchers believe that nonfunctional DNase1 or the absence of DNase1 causes cellular debris to accumulated and initiate the development of systemic lupus erythematosus (SLE).
Forgot my references.
ReplyDelete[1] Cellular Mechanism That Causes Lupus-Like Symptoms in Mice Identified. ScienceDaily. 2009. http://www.sciencedaily.com/releases/2009/10/091018141603.htm.
[2] Systemic Lupus Erythematosus. MedicineNet. http://www.medicinenet.com/systemic_lupus/article.htm#1whatis.