HEALTHLINE
are still unknown, prior infections or blood transfusions are more common in the life histories of people with these diseases than in people who do not suffer from them. The data suggests that viruses, bacteria, or foreign proteins may be triggers for what becomes a persistent immune response to proteins in the extracellular matrix. Hormonal changes and sunlight trigger some lupus bouts, and smok- ing aggravates the disease.
Diagnosis and Treatment Lupus is the most difficult connective tissue disease to diagnose because of its many and varied symptoms and its waxing and waning course. The disease can begin with a sudden onset of symptoms, or it may take many years to develop, with long periods of remission between symptomatic periods. Recurrent cycles of flu-like symptoms and skin rashes, accompanied by blood tests indicating the presence of inflammation, often lead to the correct diagnosis. One blood test called an antinuclear antibody test is usually positive in lupus pa- tients, but positive results can also occur in some perfectly healthy people. The correct diagnosis often comes when urine tests reveal that protein is being excreted by the kidneys or that inflammation is present in the body.
Inflammation in connective tissue disorders can be painful and cause great fatigue. When necessary, drugs that suppress the im- mune system are used to control the inflammation. Most people who have acquired connective tissue disorders live normal life spans. But if inflammation damages the cells of the organs that are involved in the disorder, serious illness results. When death occurs,
it is most
often the result of premature cardiovascular disease (perhaps this, too, is an acquired connective tissue disorder?), from organ failure (particularly lung, kidney, and brain failure), or from opportunistic viral and fungal infections that take hold when the immune system is suppressed by drugs being used to treat the disease. Mortality rates from lupus have decreased in recent decades because of better immunosuppressive drugs and because of advances in dialysis and kidney transplantation, but tragic deaths of young people still occur far too often. ■
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