If you are suffering from a mysterious ailment, whose symptoms mimic those of many other diseases, chances are you may have systemic lupus erythematosis.
You probably have not heard! too much about this disease? since it used to be practically impossible to diagnose.
But now that a blood test has been devised to help track it down, the diagnostic picture has vastly improved.
Various phases of this once-unrecognized ailment were discussed here Tuesday by Dr. Lawrence E. Shulman, Baltimore, Md., assistant professor of medicine, John Hopkins University School of Medicine.
Dr. Shulman w a s a featured speaker at Tuesday's session of the post-graduate course being conducted at Tulane University Medical School for doctors from all over the nation.
The John Hopkins physician said since systemic lupus erythematosis involves the connective tissues of the body, it may affect a variety of organs and tissues, "thus presenting a most confusing elin-ical picture."
"Sometimes," he explained "there may be a rash. Sometimes the patient may complain of chest pains associated with pleurisy or pneumonia. Or he may display symptoms of arthritis, Of kidney trouble, of heart trouble. His fever may zoom, going up to 105 degrees or over."
Dr. Shulman said the patient does not usually have all of these symtoms, but he may have a combination of, them.
"Interest in the disease increased recently when it was discovered that people suffering from systemic lupus erythema-tosis have a peculiar abnormality in their blood, which made recognition of the ailment possible," the physician explained. "We can now track it down with the aid of a blood test especially devised for this purpose."
Dr. Schulman said the disease is characterized by a large number of abnormal proteins in the blood.
'SYSTEM AWRY?
"It is a disease in which the immunological system in a person's body apparently goes awry," he added, "Instead of good immunity, the patient has
bad immunity. Inheritence may play a part, but this has not yet been proven."
The visiting physician said the disease tends to strike women in the prime of life, that before the advent of cortisone there was no known effective treatment, but that cortisone is achieving truly dramatic results. Another speaker at the postgraduate meeting told physicians in attendance that contrary to popular belief rheumatoid arthritis "is not always incurable."
"When the best known methods of treatment are used, a partial and sometimes a complete remission of the disease will occur in a significant number of patients," said Dr. Guv T Williams, assistant professor of medicine at the Louisiana State University Medical school. Dr. Williams, who presided at a rheumatology session Tuesday afternoon, said "sometimes the remission will be permanent." "But in other cases," he explained, "it may recur in five, 10 or 15 years."
CAUSE UNKNOWN Dr. Williams said no one knows what causes rheumatoid arthritis; a crippling ailment.
We think, however, that it is probably an auto-immune dis-ese," he explained. "This means a person starts making antibodies in his own system which are actually destructive to various human cells. In other words, it's a sort of self-destruction disease. What sets it off? It is very difficult to say
But we do know we can measure abnormal antibodies in the blood of the patient with rheumatoid arthritis or related diseases."
Dr. Schulman said although there is no cure for rheumatoid arthritis in the same sense that penicillin cures pneumonia, remissions are often obtainec with drugs previously used to I treat malaria.
'These include chloroquim and hydroxy-chloroquine," hi explained. "When carefully ap plied, gold salts, an old-time *emedy, still proves effective in some cases. With severe arth ritis, cortisone is the answe when other measures fail. No cortisone in no way effects th course of the disease. But ] does decrease joint swelling an pain, and it helps make lif more bearable for the patient. Dr. Schulman said that i order to keep general resistanc to the disease at an optimum a patient must learn to take easy.
"He #r she just cannot stay out all night, burning the candle at both ends," the physician added, "Patients with rheumatoid arthritis must modify their lives in such a way that stress is reduced. No, people aren't more prone to this disease in Louisiana. Actually it is more prevalent in Northern climes." The danger of hemorrhage, which often arises when the body dissolves clots too fast, was discussed at the meeting | by Dr. William Arrowsmith, associate professor of eliniqal medicine at Tulane University Medical school.
"The body depends on the formation of clots to control hemorrhage," the physician explained, "But the body must do its own removing of clots from undesirable spots such as in a vein or in the urinary tract.
"Although the body normally dissolves clots in the blood stream, it sometimes dissolves them too fast or too soon so that a large hemorrhage is threatened," the physician ex plained. "Well, a new drug is now available which inhibits this rapid dissolution."
Among speakers at Tuesday morning's session was Dr Charles Sprague, dean of the Tulane Medical school. His top lc was "Auto-immune Hemdlyt ic Anemias."
Sessions of the post-graduate course will last through Friday. PHOTO: Speakers at Postgraduate Medical Sessions - DR. LAWRENCE E. SHULMAN (second from left), assistant professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Md., was the principal speaker in Tuesday's sessions of the American College of Physicians postgraduate course at Tulane University School of Medicine. He chats with other speakers during Tuesday's sessions. From left are Dr. William Arrowsmith, professor of clinical medicine, Tulane; Dr. Shul-man; Dr. Charles Sprague, dean of the Tulane School of Medicine, and Dr. Guy T. Williams^ assistant professor of medicine, Lou-Isiana State University School of Medicine.
