“I think some of what’s being talked about with it is a little bit premature,” she said. “This paper isn’t actually telling us what causes lupus. We’ve known for a long time that there’s alterations in certain white cells in people who have autoimmune diseases, in particular in lupus patients.
“What this paper did is, essentially, it has added another piece to the puzzle that’s there,” Lewis said. “It has refined a little bit the understanding of one subset of white blood cells that can be abnormal in people with lupus.”
What Is Lupus?
Lupus is an autoimmune disease, meaning the body’s immune system attacks healthy cells. Lewis said it tends to affect multiple organs in the body. “So often it’ll affect the skin, the kidneys. It can affect a number of other organs.”
The complicated thing about lupus, she added, is it looks different from patient to patient. Not everybody has the same symptoms. “That makes it challenging to diagnose,” she said.
Cases are most often found in young women of childbearing age, with approximately five reported cases per 100,000 people.
“Many people have symptoms like fatigue; they might have weight loss, low-grade fevers. Very often they have some characteristic rashes,” Lewis said. “The classic rash of lupus is a rash on the face. It’s described as a ‘butterfly rash.’”
More serious cases can lead to kidney failure and inflammation around the heart and lungs, causing fluid to build up. It can also cause joint pain. Lupus patients may also have low blood counts that lead to anemia. “And some people get neurologic manifestations, so it can affect the brain,” Lewis said. “What we’re coming to realize is that patients may have some early signs of it for years before they necessarily go on to develop full-blown lupus.”
Treatment for Lupus Has Come a Long Way
The blood test to detect lupus entered circulation in 1948. “It used to be before we got a lot of our good treatment, that if somebody had lupus, their life expectancy would be quite a bit shortened,” Lewis said. Doctors couldn’t detect the disease until it was severe and there were no effective treatments for it.
More recently, Lewis said two things have happened. One is the realization that a lot of people have a mild form of lupus that can be medically managed. The second thing is that “we have a lot more effective treatments for people,” Lewis said. “Many of those treatments work by suppressing the immune system. So often, we’re very effective at shutting down inflammation that’s leading to disease flares.”
In March, Newsweek named UVA Health University Medical Center the No. 1 hospital in Virginia and among the top 40 hospitals nationally.
“I think at UVA, we’re very good at providing multi-specialty care for patients. And so particularly with lupus, that can involve a number of different organ systems,” Lewis said. “We may have the rheumatologist as being the primary person managing their treatment, but often we’re going to be working with other specialists. At UVA, it's really a multi-specialty approach to their care.”
