Lupus: The Big Bad Wolf - By: Dr. Mike DeBrule

I was planning on writing a column about stress fractures, but there is another topic of greater consequence that I can’t get off my mind: Systemic Lupus Erythematosus (known as SLE or simply lupus). Marshall, Minneota, and the surrounding communities have recently experienced firsthand the deadly effects of this autoimmune disease.

The word “lupus” and “erythematosus” are Latin for wolf and red, respectively. Back in the 1800’s, physicians believed the rash on the face of lupus patients looked like a wolf’s bite mark. Yet, the analogy to a wolf is appropriate. A wolf is a habitual creature that can sneak up on you and attack without notice. Likewise, Lupus has no known cure. Patients with lupus can feel great one minute and lousy the next.

Lupus is a disease in which the autoimmune system becomes confused. Instead of your auto-antibodies protecting you from bacteria or viruses, they begin to attack your own body (big bad wolf again). Several forms of lupus can affect any part of the body, but it mostly attacks the skin, joints, bones, blood, heart, lungs, and blood.

The autoimmune system dysfunction triggers inflammation (the primary feature of lupus). When this happens patients present with variable features frequently including: fever, weakness, fatigue, joint pain, arthritis, and red skin lesions (face, neck, upper extremities). Blood tests are often ordered to help with diagnosis.

For patients with mild lupus, the disease can be managed as a chronic illness. When I was a medical resident assigned to rheumatology, I encountered several patients with mild lupus. These patients were managed with corticosteroids and immunosuppressant drugs. All of these patients had unpredictable flares from time to time.

Systemic Lupus Erythematosus affects primarily young women. Its peak incidence occurs between the ages of 15 and 40, with a 5:1 female to male ratio. About one in 2,000 individuals are affected, making lupus more common than better known diseases like cystic fibrosis, leukemia, or multiple sclerosis.
The long term prognosis for patients with lupus depends on organ involvement. Is lupus targeting internal organs like the kidney or nervous system (poor outlook)? Or is it targeting the skin and joints (better outlook)? The most common cause of death associated with lupus is infection due to suppression of the immune system from medications used to manage the disease. Infection from meningitis would be an example.

I know this column won’t bring back the loved ones we have lost from complications of lupus. However, it is my hope that their families and friends might better understand this unfamiliar disease, grieve, and move on. No one should be scared of the big bad wolf.

About the Author

Minnesota Podiatrist Dr. Mike DeBrule treats foot problems that can cause [foot,ankle,knee,hip,back pain] using custom foot orthotics and advanced gait analysis techniques. His office is located in Marshall, Minnesota. Visit his website http://innovativefootcare.com/ For more videos go to http://www.youtube.com/user/InnovativeFootCare.

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