College-age women at risk for lupus

By LAURIE ZINBERG

When Gloria Marshall, 57, was diagnosed with lupus in 1986 in an Ohio hospital, she was… When Gloria Marshall, 57, was diagnosed with lupus in 1986 in an Ohio hospital, she was told she had six months to live. The doctors gave her such potent medications that she went blind in her right eye.

With little to hold on to, Marshall’s life changed when Susan Manzi, co-director of UPMC’s Lupus Center of Excellence, spoke at her hospital about lupus.

“Dr. Manzi didn’t put a time-span on my life because of my lupus. She gave me hope,” Marshall said.

The disease that enraptured the life of Gloria Marshall is a story shared by half a million to 1.5 million people. Ninety percent of those diagnosed are women, who are 10 times more likely to get lupus than men. Female minority groups are four times more prone to lupus than Caucasians.

Lupus is an autoimmune disease. The body’s natural immune system essentially attacks itself in a particular area. The heart, for example, might be considered foreign to the body’s immune system and the immune system will begin to wreak havoc and inflammation on the organ.

Symptoms of lupus begin to appear during a woman’s “child-bearing” age, from about 15 to 45 years old.

There are two main forms of lupus. One is systemic lupus. This form can affect one or multiple organs in the body. Each patient can be differently inflicted with the disease by the organs and symptoms involved. The most common organ to be involved is the kidney.

Marshall has systemic lupus.

“I was getting blood clots in my lungs every three months for two years. The doctors finally realized that something more serious was going on, that’s when I was diagnosed with lupus,” Marshall said.

Over time, Marshall’s lupus expanded to joint pain and problems with her digestive system, two very common symptoms of lupus.

The other common form of lupus is discoid lupus, which is external and only affects the skin and hair on patients. This kind of lupus is easier to detect because of a noticeable “butterfly” rash that commonly appears on the person’s cheeks and nose.

Doctors can take up to four years to properly diagnose a person with lupus because each patient shows symptoms differently. Left untreated or undiagnosed, lupus can be fatal if it targets any vital organ.

“Lupus patients are like snowflakes, each one is unique in its case. One patient could have it affect their brain and have seizures and Reynaud’s syndrome [blue/white fingers when cold], while another could have chest pain when breathing deeply. Both would be systemic lupus,” Manzi said.

In order to advance the process of diagnosis of lupus, Manzi and Joseph Ahearn established and are co-directors of the Lupus Center of Excellence, part of Magee-Womens Hospital.

The Lupus Center’s goal is to conduct research to learn why people get lupus and new ways to treat the disease. Also, the center offers easy-access patient care by having specialist doctors from many medical areas working with patients, since lupus can affect different parts of the body.

Only a portion of lupus patients have it genetically. Other factors, such as prolonged sun exposure and hormones, can cause the autoimmune disease.

“Lupus is sprinkled in families. Having the genetics for it doesn’t necessarily lead to lupus. It can also produce other autoimmune diseases such as muscular sclerosis. If one identical twin has lupus, there’s only a 30 percent chance of the other twin having it as well,” Manzi said.

Treatment for lupus includes giving the patient immune-suppressing drugs, similar to drugs administered to patients who just received an organ transplant.

Another form of treatment is anti-inflammatory drugs to reduce the inflammation that the immune system caused on the affected organs. Pain relievers, many with steroids, are given to suppress the common joint pain that afflicts lupus patients.

“The Lupus Center is the best thing that could have happened to lupus patients. I refer everyone here, because of the great doctors and wonderful treatment. This place gave me a second chance at life,” Marshall said.