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ID: 103
Category: Autoimmune Disease
CreatedBy: 1
UpdatedBy: 1
createdon: 10 Dec 2022
updatedon: 27 May 2023

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Author: Khoa Tran
Published Dec 10, 2022
Updated May 27, 2023

Table of contents

Lupus

Etymology and Pronunciation

Lupus (loo-puhs)
lupus - Latin for "wolf" refers to the wolf-like appearance of the rash

History of Lupus

The earliest records of a lupus-like illness date back to ancient times. Hippocrates, the father of medicine, described a skin disorder that resembled lupus in the 5th century BCE. However, it was not until the 19th century that a more comprehensive description of the disease was documented.

The term "lupus" which means "wolf" in Latin, was first used by the physician Rogerius in the 13th century to describe erosive facial lesions that resembled the bite of a wolf.

In 1851, a physician named Cazenave described a skin condition that resembled lupus, which he called lupus erythematosus. Later, in 1872, Kaposi, another physician, described a more severe form of the disease that affected internal organs, which he called lupus profundus.

In the 19th century, dermatologists such as Erasmus Wilson, Ferdinand von Hebra, and Moritz Kaposi described different forms of cutaneous lupus erythematosus (CLE), a subtype of lupus that primarily affects the skin. In 1872, Kaposi described a more severe form of the disease, which he called lupus profundus or lupus panniculitis, that affected deeper layers of the skin.

In the early 20th century, the French physician Pierre-André Léri described a systemic form of the disease that affected multiple organs and tissues. However, it was not until the 1940s that the disease was recognized as a distinct entity.

In 1948, Malcolm Hargraves, an American rheumatologist, discovered a peculiar cell in the blood of people with lupus. He called this cell the "L.E. cell" after his initials, and found that it was associated with the disease. This discovery led to the development of the L.E. cell test, which became a crucial diagnostic tool for lupus.

In the following years, researchers made significant progress in understanding the pathophysiology of lupus. It is now known to be caused by a complex interplay of genetic and environmental factors, leading to an abnormal immune response that attacks healthy tissues in the body.

Modern Understanding of Lupus

Lupus is a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, kidneys, heart, lungs, brain, and blood cells. The most common form of lupus is systemic lupus erythematosus (SLE), which is a type of rheumatologic disorder that can cause inflammation, joint pain, rash, fever, fatigue, and other symptoms. The exact cause of lupus is not fully understood, but it is believed to be a combination of genetic and environmental factors.

People with lupus may experience kidney damage, anemia, photosensitivity, and other symptoms due to the inflammation and damage caused by the autoimmune response. One of the most distinctive symptoms of lupus is a butterfly rash, which is a red rash that spreads across the face and resembles the shape of a butterfly.

Diagnosis of lupus is often difficult, as the symptoms can mimic those of other diseases. A combination of clinical examination, laboratory tests, antinuclear antibody (ANA) test, and imaging studies. This test measures the levels of antinuclear antibodies in the blood, which are antibodies that mistakenly attack the body's own cells and tissues.

Causes of Lupus

The exact cause of lupus is unknown, but it is believed to be a combination of genetic, environmental, and hormonal factors:
	- Genetics: Lupus can run in families, and certain genes are believed to increase the risk of developing the disease.
	- Environmental factors: Environmental factors such as exposure to sunlight, infections, certain medications, and chemicals can trigger lupus in people who are genetically predisposed to the disease.
	- Hormonal factors: Lupus is more common in women than men, and it often first develops during childbearing years. This suggests that hormonal factors, such as estrogen, may play a role in the development of the disease.
	- Immune system dysfunction: Lupus is an autoimmune disease, which means that the immune system mistakenly attacks healthy tissue in the body. In people with lupus, the immune system produces antibodies that attack healthy tissue, including the skin, joints, and organs.

Recent research has focused on understanding the underlying mechanisms of lupus and developing new therapies. Studies have shown that certain genetic variants are associated with an increased risk of developing lupus, and that environmental factors such as sunlight, viral infections, and certain medications can trigger the disease.

It is important for people with lupus to receive regular medical care and to participate in support groups, where they can connect with others who are living with the disease. People with lupus who have kidney involvement or serositis, which is inflammation of the tissues that line the body's organs, may require additional medical attention to manage these complications.

Treatments for Lupus

Treatment for lupus is typically tailored to the individual patient and may include the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and immunosuppressive medications. In some cases, targeted therapy with drugs such as belimumab, rituximab, and tocilizumab may be used. The goal of treatment is to control the symptoms and prevent flare-ups, which are periods of increased disease activity. Many people with lupus experience periods of remission, where they have no symptoms or very mild symptoms.

"Lupus vulgaris" is a skin disease caused by tuberculosis. In the late 1800s, a scientist named Niels Ryberg Finsen discovered that using strong ultraviolet light could help cure patients with lupus vulgaris. This method was popular for a while, but later on antibiotics became the preferred treatment.

Overall, the understanding of lupus has grown in recent years, but much work is still needed to fully understand the disease and develop new treatments. Nevertheless, new research has led to better therapies and improved outcomes for patients with lupus.

Symptoms

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Butterfly-shaped rash on the face (malar rash)
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Swollen joints
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Fever
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Chest pain
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Swollen lymph nodes
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Fatigue

Confirmation Tests

- Multianalyte panel (MAP) of autoantibodies
- Antinuclear antibody (ANA)
- Anti-extractable nuclear antigen (anti-ENA)
- Urinalysis
- Complete blood count
- Biopsy

Similar Conditions

Supplimentary Articles

Niels Ryberg Finsen was awarded the Nobel Prize in 1903 for his invention of light therapy for skin tuberculosis (lupus vulgaris)

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