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Lupus, rheumatoid arthritis are related




 

 

DEAR DR. DONOHUE: My 28-year-old daughter, who has been healthy all her life, was recently diagnosed with lupus. Will she be able to live a full life, including having children. Is there a cure? How about exercise and diet? — R.K.

ANSWER: In the 1950s, a diagnosis of lupus carried only a 50 percent chance of living for five more years. Sixty years later, the chance of living for at least 20 more years is 90 percent, and the majority of lupus patients have a normal life span.

Pregnancy is definitely possible. Doctors tell their lupus patients to delay pregnancy until the illness has been inactive for six months. That kind of delay in disease activity occurs in almost all lupus patients.

Lupus is in the same class of illness as rheumatoid arthritis. It’s an autoimmune disease, one brought on by the immune system attacking many body organs and tissues. Joints and muscles are targets. The wrists, hands, elbows, knees and ankles are the joints most often involved. Skin rashes are common. One rash is often mentioned. It’s a redness on both cheeks connected by a red bar over the bridge of the nose. This is the “butterfly” rash of lupus, seen less often than it is talked about. The kidneys, heart and nervous system can be affected.

The outlook for an individual lupus patient depends on how many organs are involved and how well the patient responds to treatment. There isn’t a cure. There are many control medicines. Lupus typically has periods of worsening and periods when the illness goes into remission. Medicines make remissions longer and longer.

Lupus has no special diet. Exercise is encouraged when the illness is in remission. You or your daughter can contact the Lupus Foundation of America for more information and for becoming acquainted with other patients in your town. The website is www.lupus.org, and the phone number is 202-349-1155.

Readers interested in learning more about lupus can order the booklet on it and rheumatoid arthritis by writing: Dr. Donohue — No. 301W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. DONOHUE: I am 66. I had been a heavy smoker, and I had a brother who died of an abdominal aneurysm. My doctor insisted I have an ultrasound of my abdomen to find out if I had one. (He thought he felt one.) It turns out I don’t have an aneurysm, but I do have a porcelain gallbladder. The doctor wants me to have surgery right away. I have no pain. I feel good. He says it’s a cancer threat. Is this so? — M.Z.

ANSWER: It is so. A porcelain gallbladder must be removed because of the high risk of cancer.

This kind of gallbladder got its name because calcium infiltrates its wall. The wall is inflamed, and gallstones are often the cause of the inflammation. Even though you might have no gallstones and even though you have no pain, you need to have the gallbladder taken out, so great is the threat of cancer developing.

Readers may write to Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

©2011 North America Synd.


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