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Improving the health of patients with lupus      11 November 2003

From Assoc. Prof. Peter Gow, Rheumatologist, Middlemore Hospital.

At a recent meeting of the lupus support group I gave a talk on the late complications of lupus, and how these might be better managed, based on a presentation which I heard at a conference in the UK . By being aware of these factors, and educating your doctor about their importance, you can improve the chances of having a long and healthy life.

In 1956 a study showed that the outlook for patients with lupus was poor, with 50% dying within 6 years. Today, over 80% of people with lupus are alive after 15 years. With modern medication, such as hydroxychloroquine for basic medical care, and immune suppressive drugs like prednisone and cyclophosphamide and azathioprine for major kidney disease, very few people die in the early years after diagnosis of lupus.

The emphasis now is not only on the good control of lupus, but also on the other factors which predict a poor outcome, such as control of infection and cardiovascular disease, including prevention of heart attacks. This means the emphasis is on control of high blood pressure, smoking, and obesity, with its associated increase in cholesterol levels. High blood pressure treatment is readily available, with a class of medications called ACE inhibitors being particularly effective, with aspirin being used to prevent stroke and heart attacks in people with high risk of these conditions.

So what can you do to increase the chances of keeping well?

• Stop smoking
• Don't put on weight (exercise is good for you)
• Ask your doctor to check your blood pressure at every visit
• Ask your doctor for your cholesterol level
• Keep a record of your medications, and understand their purpose

At Counties Manukau DHB the rheumatology department is about to do an audit of patients who attend our clinics, to see how well we are taking our own advice, with a view to improving our care of people with lupus. We will keep you informed of our progress.

Assoc. Prof. Peter Gow
Rheumatologist

Screening of Human Sera for Useful Antibodies. 27 January 2004

From Dr Maggie Kalev, Department of Molecular Medicine and Pathology, The University of Auckland.

The University of Auckland currently conducts research that aims to find in patients with certain malignant and autoimmune disorders antibodies that could be medically useful. This includes investigating patients with systemic lupus. The project is called Screening of Human Sera for Useful Antibodies.

Why we test patients with lupus?

Our aim is to look for antibodies that could help understand or treat brain injury or a low platelet count that sometimes complicate systemic lupus.

Platelet count is measured during the Full Blood Count testing. Reduced level of platelets manifests as bruising and bleeding.

Symptoms of brain injury include fits, confusion, paralysis, coma, problems with vision, difficulties with learning and memory, major mood swings, depression and psychosis.

These are important complications but currently it is impossible to predict who is at risk. Also, in patients who are affected, there is no reliable testing to monitor response to treatment or to estimate a probability of recurrence. Our research has been designed to address these difficulties.

We look for lupus associated antibodies that react with brain cells and platelets. We will then explore if these antibodies could be useful for lupus care.

Lupus patients with:

• past or present symptoms of brain injury, as described above

   

• low platelet count, measured less than 100 x 10 9 /L in the Full Blood Count

   

• other active symptoms of disease

are included in this research.

We aim to test the blood when abnormal symptoms are still present.

For the purpose of this research, we ask patients for a 10 ml blood sample . This sample can be collected at all main hospitals and hospital clinics in Auckland.

Participation is entirely voluntary (patient's choice). The testing process does not cause any side effects and does not affect patient's treatment. Blood is not sent overseas or used for genetic testing. All research procedures are performed by an experienced team at The University of Auckland.

Queries

If you have any questions about this research, or if you would like to participate, please contact the Principal Investigator, Dr Maggie Kalev.

Address:
Department of Molecular Medicine and Pathology
The University of Auckland,
Private Bag 92019,
Auckland.

Telephone: (09) 373 7599 ext. 84484 or mobile: 025 2076629.

Email: m.kalev@auckland.ac.nz

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