Summary-line: 23-Jan n, wilcox@cis.ohio-state. #Re: lupus Return-Path: Date: Wed, 23 Jan 91 08:12:48 pst From: cnorman (Cynthia Norman) To: cnorman, wilcox@cis.ohio-state.edu, luna@ccwf.cc.utexas.edu, anasaz!john@asuvax.eas.asu.edu, dwyer@nosc.mil, jgautier@ads.com, b-davis@cai.utah.edu, richter@triton.unm.edu, hxkpy@slacvm.slac.stanford.edu, botteron@bu-it.bu.edu, rollo@xylogics.com, proud@ihlpy.att.com, bill@picard.att.com, jsparkes@bnr.ca, island!green@uunet.uu.net, ann@snow-white.merit-tech.com, iex!neptune.iex.com!bert@uunet.uu.net, siang@biochem.umass.edu, smalley@pilot.njin.net, king@reasoning.com, mnetor!perle!kevin@cs.toronto.edu, afc@shibaya.lonestar.org, mark.ochsankehl@p2.f175.n120.z1.fidonet.org, abc@brl.mil, pjz@ceres.physics.uiowa.edu, ardyk@tc.fluke.com, cyn@mdaali.cancer.utexas.edu, ogicse!sequent!roseal@ucsd.edu, paulxxxx@portia.stanford.edu, andrea@sdd.hp.com, mvac23!thomas@udel.edu, ames!claris!netcom!shelamer@ucsd.edu, nick@icad.com, marks@ocfmail.ocf.llnl.gov, schillin@scl.cwru.edu, 880039a@acadiau.ca, lbrueck@wpi.wpi.edu Subject: Re: lupus Reply-To: cnorman@ucsd.edu *** EOOH *** Return-Path: Date: Wed, 23 Jan 91 08:12:48 pst From: cnorman (Cynthia Norman) To: cnorman, wilcox@cis.ohio-state.edu, luna@ccwf.cc.utexas.edu, anasaz!john@asuvax.eas.asu.edu, dwyer@nosc.mil, jgautier@ads.com, b-davis@cai.utah.edu, richter@triton.unm.edu, hxkpy@slacvm.slac.stanford.edu, botteron@bu-it.bu.edu, rollo@xylogics.com, proud@ihlpy.att.com, bill@picard.att.com, jsparkes@bnr.ca, island!green@uunet.uu.net, ann@snow-white.merit-tech.com, iex!neptune.iex.com!bert@uunet.uu.net, siang@biochem.umass.edu, smalley@pilot.njin.net, king@reasoning.com, mnetor!perle!kevin@cs.toronto.edu, afc@shibaya.lonestar.org, mark.ochsankehl@p2.f175.n120.z1.fidonet.org, abc@brl.mil, pjz@ceres.physics.uiowa.edu, ardyk@tc.fluke.com, cyn@mdaali.cancer.utexas.edu, ogicse!sequent!roseal@ucsd.edu, paulxxxx@portia.stanford.edu, andrea@sdd.hp.com, mvac23!thomas@udel.edu, ames!claris!netcom!shelamer@ucsd.edu, nick@icad.com, marks@ocfmail.ocf.llnl.gov, schillin@scl.cwru.edu, 880039a@acadiau.ca, lbrueck@wpi.wpi.edu Subject: Re: lupus Reply-To: cnorman@ucsd.edu Return-Path: Date: Tue, 22 Jan 91 21:19:42 EST From: Brinton Cooper Organization: BRL Pat Wilcox writes: > Furthermore, I am lately reading medical papers with a > distinctly heightened suspicion of the details of their explanations. > The point of the quote was that in at least one case, steroids > have been reported to exacerbate an autoimmune disease. Corticosteroids are fairly powerful immunosuppressants. However, for reasons not fully understood, the initial dose of, say, prednisone very often makes a case of myasthenia gravis much worse, occasionally causing great respiratory difficulty. This is why such drugs must be initiated only when the patient is hospitalized. This effect is temporary, however, and the patient begins to improve, usually in a few days. In general, without proper background, scientific training, and clinical experience, one must take great care in reading medical papers which seem understandable. She continues, > There are a lot of things going on with people who say they have > lupus, but this whole thing of calling this an "autoimmune" > disease is suspicious since one of the things that happens in > lupus is photosensitivity associated with perfumes, soaps, > skin preparations, etc. -- which sounds like the increasingly > familiar story of immune system attacking hapten bound to body > tissue. > Is it "people" who say they have lupus, or does she mean a diagnosed medical condition? Lupus is, I believe, fairly easy to diagnose far beyond ambiguity through the presence of certain macrophages in the blood. People who have been diagnosed with lupus should take great care to follow the orders of a competent rheumatologist or other specialist. Untreated or poorly treated lupus (actually systemic lupus erythematosis) is a fatal disease. Photosensitivity is a symptom of lupus. I wouldn't jump to the conclusion that lupus represents a misdiagnosis because of the sensitivity to certain chemicals or to sunlight. I can tell you, as a "practicing myasthenic," that paying too much attention to peripheral symptoms rather than aggressively treating the core disease is a futile exercise. Once my myasthenia was brought under control by aggressive but medically accepted therapies, many other problems "mysteriously" disappeared. > My hypothesis is that there is *one* kind of autoimmune > disease -- immune system attacking hapten bound to body tissue -- > with a dozen different names depending on which tissue is > being attacked, and a lot of overlap because the doctor gives it > the name of the disease he's most familiar with. I seriously doubt this, unless the doc is some sort of backwoods GP with a 1926 MD degree from Alexandria (Egypt) who hasn't read a journal since then. Competent specialists don't "guess" the disease based upon their familiarity; they diagnose on the basis of a complex procedure which computer scientists could write down as a tree structure. _Brint