Positive Options for Living with Lupus (19 page)

Dr. Madeleine Devey, of the Arthritis Research Campaign (ARC), believes that understanding genetics will eventually lead to POL text Q6 good.qxp 8/12/2006 7:39 PM Page 119

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much better targeted treatment for lupus. She says, “Therapy has improved markedly in recent years, and the death rate of this potentially fatal condition has fallen. In the U.K., at Imperial College, London, they are making a big effort to understand the genetics of lupus in mice, with the strong likelihood that these genes will have exact counterparts in humans.”

Meanwhile, in the U.S., researchers at the University of Minnesota recently announced that they have identified the first gene variant to be associated with lupus. Although it is found in approximately 16 percent of unaffected Caucasians, it is present in nearly 25 percent of those with lupus or insulin-dependent diabetes, another autoimmune condition. Timothy Behrens, the principal in-vestigator, says, “This is the first time we have identified a variant that predisposes [a person] to many different autoimmune diseases.” Behrens believes that dozens of genes may well turn out to be responsible for lupus and that discovering the combination of these genes will be important to developing better diagnosis and treatment of the disease.

In Closing

At first, a diagnosis of lupus may seem like a death sentence. But I hope that in reading this book you have realized that there is a worthwhile life after the bad news. If you work with the professionals and adopt a proactive approach to managing your particular lupus the beast can be tamed. And your self-esteem will be increased in the process.

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Glossary

allergic:
showing an unhealthy response to something as a result of previous exposure

alphafetoprotein (AFP):
protein produced in the fetus’s liver, and picked up in the mother’s blood, which reveals information on fetal development

androgen:
a general term for male sex hormone; testosterone is the principal male sex hormone

anemia:
shortage of oxygen-carrying red cells in the blood
angiotensin converting enzyme (ACE) inhibitor:
blood-pressure-lowering drug

ankylosing spondylitis:
form of arthritis that affects the vertebrae
antibody:
disease-fighting cell produced in response to a specific antigen
anticardiolipin:
antibody associated with blood-clotting problems
anticoagulant:
drug that reduces a tendency for the blood to clot
antigen:
something that prompts antibody reaction
antinuclear antibody (ANA):
antibody that reacts to material from the cell nucleus often present in connective tissue diseases
antioxidant:
molecule able to counteract the damaging effects of free oxygen atoms (free radicals) on the body

antiphospholipid antibody syndrome (APS):
also Hughes’ syndrome; a condition causing clots inside blood vessels and predisposing women to miscarriage

apoptosis:
programmed cell death

arrhythmia:
uneven heartbeat; an early sign of cardiovascular disease
arthritis:
inflammation of joints accompanied by pain and swelling; has many varieties

aura:
visual disturbance that sometimes precedes migraine or seizure; consists of flashing lights, bright or blind spots, blurred vision
autoimmune disease:
condition in which cells of the immune system (antibodies) attack the body’s own tissues

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autologous:
originating with the self; e.g., harvesting the patient’s own blood or stem cells

autoreactive:
acting against the body’s own tissues; used to describe antibodies

avascular necrosis:
bone or tendon damage caused by reduced blood supply

bisphosphonate:
antiosteoporosis drug

B lymphocytes:
lymphocytes that produce antibodies; see T lymphocytes
calcium antagonist:
blood-pressure-lowering drug that acts on blood-vessel walls

casein:
one of the proteins in cheese

chronic:
describes a condition that comes and goes; opposite of acute
clusters:
incidence of disease concentrated in one geographic location
cognitive behavioral therapy (CBT):
changing how someone thinks and evaluates events

colonoscopy:
internal investigation of the colon (large bowel) with fiber-optic camera

comparator:
standard treatment or drug against which a new drug is assessed

complement:
collections of proteins that support antibody activity
compliance:
following medical instructions; opposite of noncompliance
concordant:
having a characteristic in common; matching
connective tissue disease (CTD):
group of diseases (including lupus) that affect related tissues widely distributed throughout the body
core decompression:
surgical treatment for bone necrosis designed to stimulate healthy cell growth

corticosteroid, cortisone:
powerful anti-inflammatory drug modeled on a naturally occurring human hormone, cortisol

cyclooxygenase (COX):
enzyme that stimulates the production of prostaglandins; painkillers that inhibit COX-2 selectively cause fewer gastric side effects

cytokines: c
hemical messengers that communicate between cells
dehydroepiandrosterone (DHEA):
precursor to the sex hormones testosterone in men and estradiol and progesterone in women; often below normal in lupus patients

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Po s i t i v e O pt i o n s fo r L i v i n g w i t h L u p u s
deoxyribonucleic acid (DNA):
material in genes that transmits hereditary information

differential diagnosis:
evaluating a number of diagnoses and selecting the most likely

diuretic:
drug that increases fluid excretion and helps lower blood pressure
echocardiograph:
graphic representation of the interior of the heart using sound waves

E. coli:
common bacteria (names of genus and species are usually printed in Latin and italic)

edema:
accumulation of fluid in tissue spaces
electrocardiogram:
graph of the electric impulses that regulate the heart
endocarditis:
inflammation of the lining of the heart
endorphins:
chemicals produced in the brain that reduce pain and increase a sense of well-being

epidemiology:
study of disease in populations
erythema nodosum:
form of blood-vessel inflammation (vasculitis) characterized by painful, reddish nodules

erythrocyte:
red blood cell

erythrocyte sedimentation rate (ESR):
speed at which red blood cells in solution sink to the bottom of a test tube; indicator of unspecified infection or inflammation

estrogen:
one of the hormones regulating the female menstrual cycle
fibromyalgia:
rheumatic syndrome characterized by generalized muscle pain and fatigue

genome:
total information for a living system contained in DNA sequences

hematologist:
specialist in blood disorders
hematopoietic:
producing blood cells

hemophilia:
inherited, sex-linked, potentially fatal bleeding disorder caused by absence of blood-clotting factors; women carry it, men suffer it
heart-block:
heartbeat irregularities due to misfiring of electrical signals in the heart

herpesviruses:
group of common viruses (chickenpox, cold sores, shingles) that, once caught, often recur; suspected of involvement in autoimmune diseases

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iatrogenic:
caused by doctors or medical treatment
immune complex:
“clumps” of warring antibody/antigen that cause damage to surrounding tissue

incidence:
number of new cases of a disease
leukemia:
cancer of blood-producing tissue leading to overproduction of abnormal white-cell forms and a reduction of normal blood cells
lipids:
soluble fats circulating in the blood; high levels are associated with stroke and heart attack; cholesterol is a lipid
lymphocyte:
white cell active in the immune system
macular retinopathy:
damage caused by pigment deposited in the retina, the part of the eye that forms and relays images to the brain
magnetic resonance imaging (MRI):
diagnostic technique using radio-frequency pulses to create three-dimensional images of body tissues
major histocompatibility complex (MHC):
genes that code for which tissue types the body recognizes as compatible and which are rejected as foreign
malar rash:
so-called butterfly rash, usually facial, characteristic of lupus
metabolize/metabolism:
biological process by which energy is extracted from oxygen and nutrients and waste products eliminated
monoclonal antibodies (MoAbs):
synthetic antibodies targeted on a single antigen

morphogenetic:
form-generating; stimulating growth of new tissue
myalgic encephalitis (ME):
another name for chronic fatigue syndrome; see fibromyalgia, which some experts recognize as the same illness
necrosis:
tissue damage through erosion, decay, or rupture
neonatal:
immediately after birth

nephritis:
inflammation of the kidneys
nephrologist:
specialist in kidney disease
neural-tube defect (NTD):
damage to the fetal brain or spinal cord
noncompliance:
see compliance

ophthalmologist:
specialist in eye disease
opiates:
group of powerful painkillers (e.g., morphine)
osteoarthritis:
joint pain and deformity caused by wear and tear
osteonecrosis:
bone-cell decay or “death”

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Po s i t i v e O pt i o n s fo r L i v i n g w i t h L u p u s
osteoporosis:
loss of bone density leading to brittle bone and easy fracture
patellar tendon:
tendon tethering the quadriceps muscle at the front of the knee and maintaining the stability of the joint upon which the kneecap (patella) is set

pericarditis:
inflammation of the membrane surrounding the heart
pericardium:
outer membrane surrounding the heart
photosensitive:
abnormal or extreme reaction to light
placebo:
dummy pill used in clinical trials to compare the effectiveness of an active drug

placebo effect:
improvement demonstrated by patients who have been administered a dummy pill

plasmapheresis:
filtering blood outside the body to remove abnormal cells

platelet:
blood cell that initiates clotting; also thrombocyte (clotting cell)
pleura:
membrane surrounding the lungs
pleurisy:
inflammation of the membrane surrounding the lungs
polymyositis, dermatomyositis (PM-DM):
form of CTD, often occurring together, characterized by generalized muscle and skin inflammation
preeclampsia:
failure of the kidneys to filter waste products from the body during the last phase of pregnancy

prevalence:
total number of those with a condition in a given population
prognosis:
predicted outcome of a disease or treatment
prostaglandin:
substance that contributes to, and modifies, inflammation and blood clotting

prostaglandin inhibitor:
drug that inhibits the activity of prostaglandins (e.g., aspirin and NSAIDs)

psoralen:
chemical found in some plants that increases photosensitivity
pulmonary emboli:
fragments of blood clots that obstruct the lungs
pulse therapy:
administering a drug in “bursts” via intravenous injection
randomized, controlled trial (RCT):
drug test in which patients are randomly assigned to either an active or a comparator (usually standard) treatment

randomized, placebo-controlled, double-blind trial:
drug test in which treatment is tested against a patient group taking a dummy pill, and neither patients nor administering physicians know which is which POL text Q6 good.qxp 8/12/2006 7:39 PM Page 125

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Raynaud’s phenomenon
or
syndrome:
condition characterized by numb, blue fingers and toes, caused by vasospasm in response to cold or other stimuli

rheumatoid arthritis:
inflammatory CTD principally affecting multidirec-tional (synovial) joints, also blood vessels and membranes
rheumatoid factor:
antibody found in the blood of about 80 percent of rheumatoid arthritis patients and some with other inflammatory conditions

rheumatologist:
specialist in inflammatory conditions
ribonucleic acid (RNA):
building-block chemicals that transfer genetic information from DNA; unlike DNA, RNA can leave the nucleus of a cell

salmonella:
group of germs (bacilli) associated with food poisoning in humans

sclerosis, scleroderma:
hardening of connective tissue or skin
sicca syndrome:
dry eyes and mouth caused by blockage of fluid-secreting ducts by inflammation; see also Sjögren’s syndrome
Sjögren’s syndrome:
autoimmune disease that reduces the secretions of many glands of the body, resulting in severe dryness of the eyes, mouth, and vagina

statin:
lipid-lowering drug that has other beneficial side effects
systemic:
affecting organs throughout the body
systemic lupus erythematosus (SLE):
full name and acronym of lupus
therapeutics:
science of treating illness with drugs
thrombocyte:
cell that promotes clotting; see platelet
thrombophlebitis:
inflammation of veins, often in legs
tinnitus:
persistent ringing in the ears
T lymphocytes (also B lymphocytes):
subclasses of lymphocytes with different functions in the immune process