Archive by Author | Annie

Bone Fractures in lupus and other immune diseases

Short post departmemt. I just watched several videos on YouTube (where we all go for health informatIon!!) NOT 😐  The videos I found were more than interesting; both were of interviews with physicians at the meeting of the ACR (American College of Rheumatology) attended by some 15000 members.

One physician spoke of bone fractures and lupus. Were you aware that people with lupus are at an 8 times greater risk for sufferring from bone fractures? That the risk of lupus with kidney disease is more than 10 times? I sure wasn’t; the video:

Then, another physician sampled some 3000 individuals taking plaquenil (hydroxycholorquine). All lupies know of the connection between peripheral field blindness and Plaquenil and the need to have visual field studies every 6 months. Right? Read on! Of 3,000 lupus patients taking plaquenil, 0 suffered from visual field problems which lead to blindness. The blindness resulted was due to other conditions, possibly diabetes or macular degeneration.

 

 

 

 

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Immune-Suppression

Virus in blood – Scanning Electron Microscopy stylised

Finally, the combination of methotrexate, prednisone and Plaquenil™ had been titrated for my Rheumatoid Arthritis and worked ‘like a charm.’ But, after about 8 consecutive months on this ‘cocktail,’ I developed pneumonia. Strange thing; I had also been on these same meds a year ago, when another type of pneumonia was diagnosed.

In both peumonias, the ‘culprit’ was determined to be methotrexate. Methotrexate causes pneumonia? Not directly but when the immune system is suppressed by methotrexate, the body is susceptible to other germs. Not only is this true of methotrexate, but of prednisone, Humira™, Rituxan™ and other medications used in the treatment of autoimmune diseases. This supression of the immune system: immune-suppression.

These meds really stop inflammation, but at an expense. That expense? They can leave your immune system unable to mount a defense against foreign invaders. That’s why you see this admonishment in advertisements for the above meds: “make sure that you tell your doctor about any infections you have and avoid going to large public places.” My solution: have an intimate dinner at home and invite a few friends-who don’t have colds! Continue reading

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Steroids-“when they’re good, they’re very, very good; but when they’re bad, they’re horrid”

 

I used to be skinny, so skinny, that jokes followed me around. Yep, people said, “she’s like a McDonald’s hamburger; so skinny, she only has one side;” that sort of thing. Then I was diagnosed with lupus and all that changed Why?

Meds commonly used for autoimmune symptoms are often non-steroidal anti-inflammatories drugs or NSAIDs. While they don’t pack on the pounds, if symptoms worsen and other meds which include  prednisone, Decadron™ or Solu-Medrol™ are used, watch the scales for weight gain which can increase the problems one has with ‘carting around’ extra weight.

It is known that steroids cause fluid retention and an increased appetite; both of which will increase weight rapidly. All of a sudden eating that second piece of pie is completely normal behavior! Another way is theorized: interference with fat metabolism and a redistribution of body fat.

But, steroid medications do have a good effect, one so good that having the moon face and other side effects of steroids is sometimes worth the side effects. Steroids are so good at relieving the inflammation which causes the discomfort and some of the life-threatening side effects from autoimmune disease (for example, the joint pain from RA) or the inflammation of the lung lining: pleurisy. Without them there would be more pain and aches.

Steroids also play a huge role in the treatment of asthma. The asthmatic would also have to make the choice to suffer the side effects of steroids or to breathe. Kind of an untenable choice, don’t you think? But there is an increased risk of osteoporosis due to their effects on the bones. 

Also, because there is redistributing of fat, you don’t have to take steroids for autoimmunity. Ashley Judd took high dose of steroids for a sinus infection and as beautiful as she is, you can see the impact of steroids on her face.

But there are ‘new kids on the block’ which don’t have the risk/side effects of steroids; Rituxan™, methotrexate™, Benlysta™ and a host of others.

 

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Lupus Clinical Trial

This study is testing a ‘monoclonal antibody’ that may help to control the symptoms of SLE including the skin manifestations of lupus. A what? A monoclonal antibody! What’s that?

Monoclonal Antibodies (mAb) are heard of more often and have more uses, these days. But what are they? Remember, that antibodies are cells in the immune system which fight off invading organisms. Monoclonal antibodies are antibodies made by combining B lymphocytes with cancer-causing cells to the same end: to fight off invadng organisms. These cells are usually used to produce antibodies against the cancerous cells. Monoclonal antibodies are used instead of chemotherapy in patients with a form of bone cancer.

It was discovered that mAbs had uses in autoimmune diseases, like lupus, plaque psoriasis, rheumtoid arthritis to name a few. These are a few of the more common mAbs: Humira™, is a mAb, used for plaque psoriasis and Rheumatoid Arthritis. Rituxan™ is an mAb often used for lupus. Benlysta™ is an mAb often used for the treatment of SLE also. In fact, Benlysta™ was the first medication approved by the FDA for lupus treatment.

Unlike chemotherapy, which targets-well everthing, mAb’s targets specific structures (bacteria, viruses, cancer cells, etc-therefore there are fewer side effects to therapy with mAbs. Fewer side effects, more targeted medication, FDA-approved; what’s not to like?

Click here to be directed to the questionairre to see if you qualify for the clinical trial!

 

 

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The bleeding won’t stop!

Idiopathic Thrombocytic Purpura. Say what? Forget that it’s difficult to pronounce; what the heck does it mean? You’ve heard of red cells and white cells in the blood. There is another kind of cell; that cell is the platelet.

Technically speaking, platelets aren’t cells because they lack DNA. (To be considered ‘real’ cells, ‘cells’ need a nucleus with DNA). Platelets lack DNA, so technically they are not cells). But they, platelets (thrombocytes) cause the blood to clot.

People who have lupus can have low numbers of platelets for several reasons. In lupus and in all autoimmune diseases, cells of the immune system attack other cells. When platelets are attacked and killed, their numbers are decreased resulting in thrombocytopenia (low platelets in the blood); blood may or may not clot. That is one of the many reasons they check your platelet count before surgery. Can you see the headlines now? ‘The operation was a success, but the patient bled to death!’ It has happened.

Another reason that people with lupus might have low platelets is APS or antiphospholipid syndrome; another clotting disorder, often caused by lupus which increases the likelihood of blood-clotting. How could this be so? An increased likelihood of clotting at the same time there is a decreased likelihood? Platelets are so busy causing blood to clot in in all parts of the body, that in some areas, there are not adequate numbers of them to cause blood to clot. So much for the thrombocyte (thrombocytic) part. So much for the thrombocytic part and on to the idiopathic part!

‘Idiopathic’ simply means docs don’t know what causes something to happen. 

Purpura is a simple reference to what can happen when blood fails to clot. Blood may pool close to the skin surface, eventually clot and there is a resulting purplish discoloration; purpura or in it’s very technical term: bruising!

There you have it, ITP or Idiopathic Thrombocytic Purpura, sometimes not hazardous, but it can be serious and depending upon the severity, ITP may or may not be treated,. If it is treated, Plaquenil,™ steroids, Benlysta,™ CellCept™ or mycophenolate are among many meds of choice Other treatments can be Rituxan™ or in more severe cases, the surgical removal of the spleen (splenectomy). New treatments are in clinical trials, now.

 

 

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