Talk:Lupus/Archive 2

Archive 1

Archive 2

MCOTW

This article is now MCOTW. The article has been the subject of longstanding gradual improvement, but it needs a push to maximum quality. Given its protean symptoms and uncertain etiology it is really tempting to get drawn into speculation, and therefore we need to be stricter than ever with the reliability of sources. I'm personally tempted to restrict the main sources to core general medical and rheumatological journals, and only general and systematic reviews are to be used.

These are the reviews that seem to be the most suitable:

• Lancet 2007 doi:10.1016/S0140-6736(07)60279-7 (from the Hughes/St Thomas group, well know to employ alternative criteria)
• NEJM 2008 doi:10.1056/NEJMra071297 (from Rahman/Isenberg, acknowledged experts)
• BMJ 2007 doi:10.1136/bmj.39358.519491.AD (from BMJ, focus on pregnancy)
• BMJ 2006 doi:10.1136/bmj.332.7546.890 (from BMJ, by D'Cruz from the St Thomas group)

We definitely need to cover fairly recent developments (which the reviews will cover) such as accelerated atherosclerosis, the therapeutic utility of mycophenolate, overlap syndromes, childhood lupus, pregnancy in lupus patients, neonatal lupus. JFW | T@lk 10:57, 1 February 2009 (UTC)

lupus vs SLE

I have just gone through and changed relevent uses of 'lupus' to SLE, as before article was alternating. Although I think it would read better if the word was used rather than the abbreviation. I have also realised a number of sections e.g. treatment where using the term 'Lupus erythematosus' alone - which I may of changed for SLE, but if they are not SLE they may be wrong ... you may have to revert my changes if the two aren't interchangeable for the section in this article. :( LeeVJ (talk) 20:24, 3 February 2009 (UTC)

Information about longevity

I'm wondering about this addition - the journal does not seem to be pubmed indexed, and may be on-line only in an uncertain journal. It also doesn't seem to appear in google scholar. Would it be possible to substitute a more obviously reliable publication? WLU (t) (c) Wikipedia's rules:^simple/_complex 23:10, 19 August 2009 (UTC)

Anaesthetic and Lupus

My doctor won't operate,he says they are scared of giving anaesthetic with the Lupus, why would this be,is it dangerous? —Preceding unsigned comment added by 41.19.3.49 (talk) 12:11, 4 September 2009 (UTC)

Ask him? JFW | T@lk 21:49, 5 September 2009 (UTC)

Possibly the agent used would not do your kidneys any favours. But as the user above stated, ask him...or her :) —Preceding unsigned comment added by 84.10.220.180 (talk) 19:24, 14 September 2009 (UTC)

203.211.107.129 (talk) 01:59, 11 January 2010 (UTC) I've got SLE with ANA and have low white blood cells etc but I've gone under General Anaesthetic twice since I found that I have lupus and had number local anaesthetic without any prob. It may be depend on your condition how far off or bad your SLE is? Better ask your doctor... :)

I WANT TO KNOW THE OUT COME OF LUPUS/SLE —Preceding unsigned comment added by 63.139.223.130 (talk) 20:44, 31 January 2010 (UTC)

Merge proposal

Stem cell transplantation for systemic lupus erythematosus is a tiny stub that should probably be merged into the treatment section here. WhatamIdoing (talk) 20:46, 17 February 2010 (UTC)

It is also utterly experimental, and I even doubt that it should even be mentioned here unless a very good source is provided. I've sent the stub to AFD. JFW | T@lk 10:21, 18 February 2010 (UTC)

Merge proposal

Wondering if lupus erythematosus should be merged here and either redirected or turned into a disambig? Doc James (talk · contribs · email) 21:55, 17 May 2010 (UTC)

It is essentially already a disambiguation page. JFW | T@lk 07:50, 31 May 2010 (UTC)

Lupus and the brain

This should really be merged here.Doc James (talk · contribs · email) 20:20, 31 May 2010 (UTC)

Merged. Doc James (talk · contribs · email) 18:45, 8 September 2010 (UTC)

Nice work! :) By the way, do you think you can get your hands on any recent scans? That "brain scan" image (I guess it's a scintigram?) is a whopping 32 years old. Conventional radionuclide scanning has long been superseded by MRI and SPECT in this setting. Fvasconcellos (t·c) 19:33, 8 September 2010 (UTC)

I will ask over at radiology. I havn't done imaging on a case in my practice.Doc James (talk · contribs · email) 20:25, 8 September 2010 (UTC)

Picture of lupus butterfly rash

This is actually a poor picture of the butterfly rash, probably since it's not real. Classically, the lupus rash "spares the nasolabial folds" which this picture doesn't do. Type in lupus rash in Google images and you will see what I mean. Almost every time the nasolabial folds are spared. I happened to notice this since I was studying for my boards right now and something looked off about the picture.Chrisscrewball (talk) 07:59, 15 November 2010 (UTC)

Unless someone uploads a higher quality image with the right permissions this is not likely to change. JFW | T@lk 08:53, 15 November 2010 (UTC)

chances are

what are my chances when being positive in ANA and negative in anti strand and anti smith

No point asking a complete bunch of strangers on a website. At the same time, ANA positivity is exceedingly common. What matters is the clinical presentation (i.e. symptoms), the ANA titer and the IF pattern. JFW | T@lk 14:03, 20 December 2010 (UTC)

Aspartame

Shouldn't something be mentioned about the link with Aspartame? Saw nothing about this in the article. —Preceding unsigned comment added by 82.39.48.187 (talk) 15:17, 30 January 2011 (UTC)

Provide a reliable medical source, and it might be worthy of inclusion. More likely, it sounds like it might be a bit tenuous. JFW | T@lk 18:24, 30 January 2011 (UTC)

Images

We could use a real image rather than a drawing in the lead.Doc James (talk · contribs · email) 19:58, 28 May 2010 (UTC)

Artists impression? Unbeleivable! No image at all would be preferable to such a woeful likeness. The "artist" (photoshop amatuer more like it) has overemphasised the subtle hues of the general case rash such that most people would, based on this image, miss an actual lupus rash when presented with the real thing. This is closer to a face painting than a lupus rash. Its a mockery and should be removed immediately, pending its replacement with a public domain reprentative image of a real general case. Abunyip (talk) 18:35, 27 July 2010 (UTC)

Agree, could someone provide a better image? Doc James (talk · contribs · email) 18:47, 27 July 2010 (UTC)

I completely agree. The malar rash in this drawing does not correspond to the actual regions of light exposure at all and looks nothing like the actual rash seen on patients with SLE. This is a travesty. I'm going to remove the image, as I agree that no image is better than a misleading image. Hopefully someone can find an image that is actually illustrative of the malar rash seen in SLE. —Preceding unsigned comment added by 173.52.182.136 (talk) 16:05, 5 March 2011 (UTC)

kids?

can kids get lupus? —Preceding unsigned comment added by 76.186.15.139 (talk) 00:04, 16 March 2011 (UTC)

Yes, but it is very rare. More common in those with inborn deficiencies of the complement system. JFW | T@lk 00:38, 16 March 2011 (UTC)

Opening paragraph and bulleted list.

I'm not very familiar with Wikipedia editting so bear with me if I foul something up. The opening paragraph seems to jump to a bulletted list of... something, with no explanation of what that list is or why it's relevant. I THINK it's a list of similar diseases/variations, but don't have the expertise to write a transition or move it to a more appropriate section. 75.163.232.114 (talk) 06:41, 26 June 2009 (UTC)

It is a list of other forms of lupus. It doesn't belong there or probably anywhere else in the article. JFW | T@lk 06:51, 28 June 2009 (UTC)

• Chronic cutaneous lupus erythematosus
  • Discoid lupus erythematosus, a skin disorder that causes a red, raised rash on the face and scalp. Discoid lupus occasionally (1–5%) develops into SLE.
    • Localized discoid lupus erythematosus
    • Generalized discoid lupus erythematosus
    • Childhood discoid lupus erythematosus
  • Chilblain lupus erythematosus (Hutchinson)
  • Lupus erythematosus-lichen planus overlap syndrome
  • Lupus erythematosus panniculitis (Lupus erythematosus profundus)
  • Subacute cutaneous lupus erythematosus, which causes nonscarring skin lesions on patches of skin exposed to sunlight.
  • Tumid lupus erythematosus
  • Verrucous lupus erythematosus (Hypertrophic lupus erythematosus)
• Neonatal lupus erythematosus, a rare disease affecting babies born to women with SLE, Sjögren's syndrome, or sometimes no autoimmune disorder. It is theorized that maternal antibodies attack the fetus, causing skin rash; liver problems; low blood counts, which gradually fade; and heart block, leading to bradycardia.
• Childhood systemic lupus erythematosus, the pediatric variant of systemic lupus erythematosus.
• Drug-induced lupus erythematosus, a drug-induced form of SLE; this type of lupus can occur equally in either sex.
• Lupus nephritis, an inflammation of the kidneys caused by SLE.
• Complement deficiency syndromes

These links might become part of a good "See also" section at the bottom of the articles. They seem to refer to other related WP articles beyond the scope of this one but of more interest to certain readers.

Ocdnctx (talk) 19:17, 16 May 2011 (UTC)

They should be discussed in context. Why would a non-expert understand why complement deficiency is related to lupus? JFW | T@lk 13:05, 17 May 2011 (UTC)

File:Lupus Brain.jpg Nominated for Deletion

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Needs an introductory picture of a butterfly rash

Needs an introductory picture of a butterfly rash —Preceding unsigned comment added by Ocdnctx (talk • contribs) 19:11, 16 May 2011 (UTC)

Please find us one. We used to display a photoshopped one that was not illustrative. JFW | T@lk 13:06, 17 May 2011 (UTC)

Agree but it is not that common.Doc James (talk · contribs · email) 17:19, 17 May 2011 (UTC)

Here's a link to a few pictures: http://cure4lupus.org/store/index.php?main_page=page&id=187&chapter=1. Could we ask permission to use one? The second one down is especially good, because it illustrates that it doesn't really look like a rash in the usual sense (not 3-d), just a serious but oddly localized sunburn. You can also see that it doesn't extend as far back on the cheeks as the drawing here does. This is almost exactly what mine looked like. I'm in remission now, but I promise to submit a photo to WP should I be unfortunate enough to get that horror-show redface again.--TEHodson 21:14, 29 July 2011 (UTC)

Can we use a link in the article?--TEHodson 21:15, 29 July 2011 (UTC)

Image 6 has the best picture quality. If you can convince them to release the images under a cc license then we can use them. I have had some success doing this.--Doc James (talk · contribs · email) 21:16, 30 July 2011 (UTC)

File:Lupus facial rash.jpgJidanni (talk) 15:18, 30 September 2011 (UTC)

This one is photoshopped. The drawing is superior. Doc James (talk · contribs · email) 15:24, 30 September 2011 (UTC)

Contagious?

The "Transmission" section should come right out and say if it is contagious using plain English. Jidanni (talk) 15:20, 30 September 2011 (UTC)

It is not contagious. Doc James (talk · contribs · email) 15:25, 30 September 2011 (UTC)

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"there is currently no cure" should include a date, perhaps year, or year and month.

I wrote requirements for many years for cellular infrastructure and learned you have to be very careful with subjective terms such as "currently". Granted, as of 20120415 at 00:32 central time there may be no cure, but what about "tomorrow" (20120416)?

Please use whatever data/source you (the author) had available at the time you wrote this and rephrase it like "as of <month, year> there is no cure" or "currently (month, year) there is no cure" (or medically approved cure - and y'all can debate what's medically approved). — Preceding unsigned comment added by PReinie (talk • contribs) 05:37, 15 April 2012 (UTC)

There is a risk of WP:RECENTISM here. In medicine, few breakthroughs are completely unanticipated. I can say with reasonable certainty that there will be no "cure" for lupus tomorrow (a treatment that will bring permanent drug-free remission), or in the foreseeable future. For information that is likely to change quickly, the template {{as of}} may be used, but as per this guideline such a move would not be appropriate here. JFW | T@lk 18:41, 15 April 2012 (UTC)

Pop Culture

"It's not lupus" - Dr. Gregory house — Preceding unsigned comment added by 108.92.110.184 (talk) 18:47, 3 September 2012 (UTC)

He doesn't say this nearly as often as everyone suggests. We are not mentioning it here anyway. JFW | T@lk 22:43, 3 September 2012 (UTC)

Survival data 2012

These are the latest figures, though not necessarily the best. Basically 10-year survival was 85% in the period 1970-1993, and 95% for 1993-2011. That's better than the 90% cited in the current article, from the 17th edition of Harrison's.

From the American College of Rheumatology meeting 2012:
http://www.rheumatology.org/apps/MyAnnualMeeting/ExploreMeeting/AbstractDetail?abstractId=28527
Changes in Ten Year Survival Among SLE Patients At an Academic Center in North America (1970-2011)
Presenter: Joseph F. Merola: Brigham and Women's Hospital, Harvard Medical School

Also what appears to be a WP:RS:
http://www.healio.com/rheumatology/systemic-lupus-erythematosus/news/online/%7B1BD87AC2-38FD-4EC2-B793-98867C31241D%7D/Survival-rates-for-lupus-patients-improved-from-1970-2011
Survival rates for lupus patients improved from 1970-2011
--Nbauman (talk) 20:42, 9 December 2012 (UTC)

Nonsense!

What on earth is this sentence supposed to mean?:

"As many as 30% of sufferers have some dermatological symptoms (and 65% suffer such symptoms at some point), with 30% to 50% suffering from the classic malar rash (or butterfly rash) associated with the disease."

Could someone sort out which percentage is the most relevant, and then add a reference? You can not possibly have "[only] as many as 30%" followed by "65 per cent at some time". Make up your mind!

Amandajm (talk) 21:46, 17 November 2012 (UTC)

You can have 30% with dermatological symptoms at any one time, and 65% with dermatological symptoms at some time in their lives. --Nbauman (talk) 15:53, 8 July 2013 (UTC)

NEJM review article

This is the latest review article I could find. Does anybody have a better one?

http://www.nejm.org/doi/full/10.1056/NEJMra1100359

N Engl J Med. 2011 Dec 1;365(22):2110-21. doi: 10.1056/NEJMra1100359.

Systemic lupus erythematosus.

Tsokos GC. Division of Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. gtsokos@bidmc.harvard.edu

PubMed search: ("review"[Publication Type] AND "lupus erythematosus, systemic"[MeSH Major Topic]) AND ((("The New England journal of medicine"[Journal] OR "JAMA : the journal of the American Medical Association"[Journal]) OR "Lancet"[Journal]) OR "BMJ (Clinical research ed.)"[Journal])

--Nbauman (talk) 08:01, 7 July 2013 (UTC)

Here are a couple of Medscape articles that are not bad.

http://www.medscape.com/viewarticle/803425?src=wnl_edit_specol&uac=34470ET Medscape Rheumatology A New Era in Lupus Therapy Ronald F. van Vollenhoven, MD, PhD May 07, 2013

http://emedicine.medscape.com/article/332244-overview?src=wnl_edit_specol&uac=34470ET#showall Systemic Lupus Erythematosus (SLE) Author: Christie M Bartels, MD, MS Updated: Jan 28, 2013

--Nbauman (talk) 17:18, 24 July 2013 (UTC)

I do not typically consider emedicine to be a particularly good source as it is unclear what sort of review they undergo. Also there are concerns regarding COI per [5]. I see the review articles as being much superior.Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:21, 24 July 2013 (UTC)

I don't either, but it's a convenient, easy read which is free online. The therapy article has a nice organized outline of the SLE therapies, which this WP article (in the Treatment section) does not have. --Nbauman (talk) 22:01, 24 July 2013 (UTC)

P.S. I remember that NYT magazine story because it made an impression on me when I first read it. It struck me as a good example of the belief among newspapers that a good journalist can write about anything, whether she has any expertise in the subject or not. Virginia Heffernan doesn't know anything about medicine. She's reviewing medical web sites the way she might review a movie. She's not a great journalist either. She attacked someone without bothering to call them for a response, which might be why she's not at the NYT any more.

I have my problems with WebMD, but the Mayo Clinic web site isn't that great either. http://www.mayoclinic.com/health/osteoarthritis/DS00019/DSECTION=alternative-medicine

BTW, Heffernan is a creationist. http://news.yahoo.com/why-im-a-creationist-141907217.html Even worse, she doesn't believe in (or udnerstand) double-blind studies. --Nbauman (talk) 23:11, 24 July 2013 (UTC)

Here's one from Annals of Internal Medicine. It has the virtue of being up-to-date, with sources from 2012 and 2013. It's a clinical review, not much basic science, but it distinguishes carefully between drugs that have been demonstrated in randomized controlled trials and drugs that haven't been.

http://annals.org/article.aspx?articleID=1743105 Systemic Lupus Erythematosus Annals of Internal Medicine, October 1, 2013 --Nbauman (talk) 08:01, 5 October 2013 (UTC)

Semi-protected edit request on 19 March 2014

Mnemonic

DOPAMINE RASH

D Discoid Rash O Oral Ulcers P Photosensitivity A arthritis M Malar Rash I Immunological Criteria N Neurological Symptoms E Elevated ESR

R Renal Disease A ANA positive S Serositis H Hematological Abnormalities Kshah13788 (talk) 04:49, 19 March 2014 (UTC)

Maybe this would be better over at Wikiversity? Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:46, 19 March 2014 (UTC)

Not done: it's not clear what changes you want made. Please mention the specific changes in a "change X to Y" format. Sam Sailor ^Sing 09:26, 19 March 2014 (UTC)

miscarriage replaced with 'spontaneous abortion'

Please correct hyperlink to 'spontaneous abortion' as it points to 'miscarriage' and not to 'spontaneous abortion'. Please either change 'spontaneous abortion' to 'miscarriage' or update hyperlink. — Preceding unsigned comment added by Ramtatatam (talk • contribs) 12:27, 28 April 2014 (UTC)

Famous person who has it - "Seal"

Seal (musician) has this disease 129.180.139.40 (talk) 02:51, 6 September 2014 (UTC)

No he doesn't. JFW | T@lk 21:04, 10 September 2014 (UTC)

History of SLE

I am student with UOIT participating in the Wikipedia Education Program and I updated the history section of this article to provide a fuller history of the work done from medieval to modern times in the observations, research, and diagnosis of SLE.--Heatherj963 (talk) 14:29, 28 November 2014 (UTC)

Hello Heatherj963. Could you remove the titles of the authors from the references? Otherwise good work! JFW | T@lk 21:37, 29 November 2014 (UTC)

Thank you for your kind words. I have removed the titles of the authors from my references as requested. Heatherj963 (talk) 03:11, 1 December 2014 (UTC)

Headaches

Greenmachine21 added several paragraphs on headache to the article. I worry greatly that this level of detail is going to bloat the article. There are loads of sources that could potentially be used to expand this article, and one needs to be selective.

In general, the article is receiving a large number of edits without any discussion or at least some sort of systematic approach. Can I encourage the students who are clearly working on this to collaborate on this talk page to maximise the flow and readability of the article? JFW | T@lk 21:51, 8 December 2014 (UTC)

A few comments to the students:

• Please also include PMIDs per WP:MEDHOW
• Ref goes AFTER the punctuation
• Only use secondary sources. You can limit your search on pubmed to just review articles.

Doc James (talk · contribs · email) 22:36, 8 December 2014 (UTC)

Semi-protected edit request on 10 February 2015

Grammatical error (missing apostrophe): " against a persons own proteins" should be changed to "...person's..."

Steve Thackery (talk) 22:31, 10 February 2015 (UTC)

Done — {{U|Technical 13}} (e • t • c) 22:52, 10 February 2015 (UTC)

Lancet Seminar 2014

--Nbauman (talk) 06:00, 2 June 2014 (UTC)

Contains the following:

Panel 2: Environmental triggering factors in systemic lupus erythematosus

• Sunlight

• Cigarette smoking

• Infection

• Vaccine*

• Vitamin D deficiency

• Exogenous oestrogen

• Conventional drugs

• Biological agents

• Pesticides

• Phthalates

*There are many anecdotal case reports of induction or exacerbation of systemic lupus erythematosus after immunisation, but overall these instances are rare.

--Nbauman (talk) 17:53, 12 July 2015 (UTC)

Semi-protected edit request on 20 July 2015

Butterfly rash across the nose occurs in only 30% of patients with SLE. Please add this fact and change the picture depicting a woman with a butterfly rash - stereotypical but inaccurate presentation of an average SLE patient. Miccika1 (talk) 22:38, 20 July 2015 (UTC)

Reference needed. And why remove the picture? This occurs in 30% of people. Doc James (talk · contribs · email) 17:12, 21 July 2015 (UTC)

Okay found a ref and added 30% to 60%. Doc James (talk · contribs · email) 17:15, 21 July 2015 (UTC)

Hereditability

Kuo C, Grainge MJ, Valdes AM, et al.
Familial Aggregation of Systemic Lupus Erythematosus and Coaggregation of Autoimmune Diseases in Affected Families.
http://archinte.jamanetwork.com/article.aspx?articleID=2397732
JAMA Intern Med. Online July 20, 2015. doi:10.1001/jamainternmed.2015.3528

Great article, great Taiwan National Health Insurance Research Database. Unfortunately results are limited to 95% Han Chinese population. --Nbauman (talk) 03:21, 24 July 2015 (UTC)

As a cohort study it's a primary source.

The figure quoted for heritability is much larger than what I recall learning/reading (10-15%). Does that mean that there are a lot of genetic loci in the Han Chinese of Taiwan that explain linkage? JFW | T@lk 13:27, 24 July 2015 (UTC)

Semi-protected edit request on 4 September 2015

See also

• Lupus erythematosus for other types of the condition
• Canine discoid lupus erythematosus in dogs
• List of cutaneous conditions
• Lupus Canada
• The Hibbs Lupus Trust

Hibbslupustrust (talk) 15:00, 4 September 2015 (UTC)

Not done. There are dozens of these charities. We do not typically link to them all. Also what is your relation to the charity in question? Best Doc James (talk · contribs · email) 21:58, 4 September 2015 (UTC)

Selena Gomez has lupus

Just recently blew up in the news, she should be added to the section of notable people who are afflicted 68.7.217.28 (talk) 16:33, 8 October 2015 (UTC)

Diagnostic criteria

The article briefly discusses diagnostic criteria for lupus, saying that many physicians use criteria established by the American College of Rheumatology (ACR). It's pointed out, however, that these criteria "were established mainly for use in scientific research" and "were not intended to be used to diagnose individuals."

In contrast to the ACR criteria, there are newer criteria called the SLICC (Systemic Lupus International Collaborating Clinics) Classification. Unlike the ACR criteria, the SLICC criteria are intended for diagnostic purposes. I'm curious to know why there is no mention of the SLICC criteria in the article. There is more information here: http://www.apiindia.org/medicine_update_2013/chap99.pdf Doncoulter (talk) 23:47, 8 October 2015 (UTC)

Semi-protected edit request on 25 October 2015

There is a sentence (in paragraph 4 in the introduction) that makes no sense in the text it is...

Rates of disease is the developing work are unclear.

perhaps it should say Rates of disease in the developing world are unclear.

that is my suggestion anyway.

Pdfjeff (talk) 23:38, 25 October 2015 (UTC)

Done Thanks for catching that Cannolis (talk) 01:25, 26 October 2015 (UTC)

Proposed merge with Lupus erythematosus

duplicate content Gizmocorot (talk) 18:17, 18 October 2015 (UTC)

One is a group of diseases, the other is a single disease. Thus oppose. Doc James (talk · contribs · email) 06:51, 19 October 2015 (UTC)

Merge. Readers want to know about lupus. There may be different types of lupus - that point can be made in the article. There is lots of duplicate content and uncertainty about which page should be read to learn about lupus. Bangabandhu (talk) 01:45, 26 November 2015 (UTC)

We can still use hatnotes. Merging different types of a disease into one article about another type of this disease would be even more confusing to the readers. Think about it. Fitzcarmalan (talk) 07:11, 14 January 2016 (UTC)

Appose. If we do this then we should while we are at it, just merge all lupus related articles into one huge massive article. AManWithNoPlan (talk) 17:52, 13 January 2016 (UTC)

• Oppose per others. Fitzcarmalan (talk) 07:11, 14 January 2016 (UTC)

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Causes vs pathophysiology

Currently we have separate sections on causes and pathophysiology. The only real suspected causes for lupus, according to Rahman & Isenberg, are genetics, viral infections (none definitely identified, EBV suspected), drugs and sunlight. I think we should put these in a smaller "causes" section and put all other information on immune dysregulation and pathogenetic antibodies in a section on "pathophysiology" that also outlines the main pathological findings. JFW | T@lk 16:49, 1 February 2009 (UTC)

Lancet lists sunlight, drugs, Epstein-Barr virus, abnormalities of apoptosis, abnormal signal transduction of toll-like receptors, cytokine patterns (interferon signature; decreased interleukin 2 from T cells), genetics (i.e. CRP, serum amyloid P genes, FcγR receptors, apoptosis errors) and occupational exposure to silica, pesticides and mercury. Sunlight and occupational exposure I have just put into 'lifestyle' under treatment, but I'd support your changes of it being moved to causes, and have the rest put into pathophysiology. —Cyclonenim (talk · contribs · email) 17:05, 1 February 2009 (UTC)

There is considerable evidence linking trans fat in food to autoimmune disease and raised levels of inflammatory markers, especially in women. One of the studies is 'Dietary intake of trans fatty acids and systemic inflammation in women' by Mozaffarian D, Pischon T, Hankinson SE, Rifai N, Joshipura K, Willett WC, Rimm EB, in the Am J Clin Nutr. 2004 Apr;79(4):606-12. PMID: 15051604 . Could it be possible that high trans fat diet actually causes S L E ? Fullwill (talk) 19:36, 29 July 2011 (UTC)

Alfalfa contains L- Canavanine, that have its highest concentrations in its seeds and sprouts. This substance replaces the amino acid arginine in protein making the protein look foreign to cause a relapse of SLE. SLE patients should not consume alfalfa products. Source: Pharmacognosy 9th edition by Varro E. Tyler, Lynn R. Brady, and James E. Robbers, 1988, page 460. — Preceding unsigned comment added by Ribazole (talk • contribs) 16:00, 31 May 2016 (UTC)

Semi-protected edit request on 10 September 2016

Interferons (IFN) in the pathogenesis of SLE In the last decade growing evidence of a role of IFN in the pathogenesis of SLE has emerged to an extent that IFN inhibitory therapies are tested in clinical trials. The IFN type I signature correlates with the disease activity of patients with SLE (1,2). IFNs have a pleiotropic effect on almost all cells of the immune system and therefore it is believed it is the central cytokine in the pathogenesis. About 80% of SLE patients show an upregulation of IFN regulated gene (IFN gene signature).(3) The IFN type I is difficult to detect in the peripheral blood because ELISA systems are insensitive. Therefore indirect read-outs of the IFN-signature in response to IFN are investigated in order to evaluate those IFN-biomarkers in clinical practice. IP-10 and SIGLEC1 as response proteins are potential candidates to evaluate the IFN-signature in SLE patients.(4,5) Altohugh IFNs are central cytokines in the pathogenesis of SLE IFN-biomarkers are not used in clinical practice and no guidelines exist wether it is advantageous compared to the gold standard (anti-dsDNA ab and complement factor 3). IFN-biomarker might be interesting for selecting patients with an enhanced IFN signature for the introduction of IFN inhibitory medications such as hydroxychloroquine.(6)

1. Bengtsson AA, Sturfelt G, Truedsson L, Blomberg J, Alm G, Vallin H, et al. Activation of type I interferon system in systemic lupus erythematosus correlates with disease activity but not with antiretroviral antibodies. Lupus. 2000;9(9):664–71.

2. Feng X, Wu H, Grossman JM, Hanvivadhanakul P, FitzGerald JD, Park GS, et al. Association of increased interferon-inducible gene expression with disease activity and lupus nephritis in patients with systemic lupus erythematosus. Arthritis & Rheumatism. 2006 Sep 1;54(9):2951–62.

3. Banchereau R, Hong S, Cantarel B, Baldwin N, Baisch J, Edens M, et al. Personalized Immunomonitoring Uncovers Molecular Networks that Stratify Lupus Patients. Cell. 2016 Apr 21;165(3):551–65.

4. Kong KO, Tan AW, Thong BYH, Lian TY, Cheng YK, Teh CL, et al. Enhanced expression of interferon-inducible protein-10 correlates with disease activity and clinical manifestations in systemic lupus erythematosus. Clin Exp Immunol. 2009 Apr;156(1):134–40.

5. Rose T, Grutzkau A, Hirseland H, Huscher D, Dahnrich C, Dzionek A, et al. IFN and its response proteins, IP-10 and SIGLEC-1, are biomarkers of disease activity in systemic lupus erythematosus. Annals of the Rheumatic Diseases. 2013 Oct 1;72(10):1639–45.

6. Costedoat-Chalumeau N, Dunogué B, Leroux G, Morel N, Jallouli M, Guern VL, et al. A Critical Review of the Effects of Hydroxychloroquine and Chloroquine on the Eye. Clinic Rev Allerg Immunol. 2015 Feb 12;49(3):317–26.

Thorose (talk) 14:57, 10 September 2016 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. Dat Guy^Talk_Contribs 22:32, 10 September 2016 (UTC)

Semi-protected edit request on 15 August 2017

Antiphospholipid has nothing to do with Systemic Lupus Erythamatosus, they are totally separate disorders with totally different tests required. Please read information freely available on the Internet where the top professionals in Rheumatology make it abundantly clear that these two diseases are not the same, but one does mimic the other.

The current information on this page is misleading and any patient trying to get a doctor to listen to them will go armed with this useless information. 77.98.52.230 (talk) 10:51, 15 August 2017 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. nihlus kryik (talk) 15:33, 15 August 2017 (UTC)

• Would also note that systemic lupus erythematosus and antiphospholipid syndrome are linked (supported by MEDRS such as PMID 28411166); therefore, while it is true that different tests are needed to diagnose each, they are biologically linked. — soupvector (talk) 04:48, 17 August 2017 (UTC)

• I have added a statement that more clearly links SLE with antiphospholipid syndrome. Axl ¤ [Talk] 10:53, 17 August 2017 (UTC)

List of people

per MEDMOS we generally do not have sections like this. We list people only if there are reliable sources that say that the person having the disease, had some impact on its history.

Notable cases==

• Louisa May Alcott, American author best known for her novel Little Women; has been suggested to have had SLE
• Inday Ba (also known as N'Deaye Ba), Swedish-born actress; died from SLE complications at age 32
• Toni Braxton, hospitalized in Los Angeles in December 2012 because of "minor health issues" related to lupus
• Donald Byrne, American chess player; died from SLE complications in 1976
• Nick Cannon, American actor and former presenter of America's Got Talent
• Lauren Shuler Donner, American movie producer
• Caroline Dorough-Cochran, died of SLE complications; sister of Howie D. of the Backstreet Boys, who founded the Dorough Lupus Foundation in her memory
• Pumpuang Duangjan, "queen of Thai country music"
• Juli Furtado, champion professional mountain biker
• Hugh Gaitskell, British politician; died of SLE complications in 1963 aged 56
• Selena Gomez, American actress and singer
• Sophie Howard, British glamour model
• J Dilla (also known as Jay Dee), hip-hop producer and beat maker; died of SLE complications in 2006
• Michael Jackson, had both SLE and vitiligo; diagnosed in 1986, and confirmed by his dermatologist, Arnold Klein, who presented legal documents during court depositions
• Teddi King, American singer; died of SLE complications in 1977
• Charles Kuralt, former anchor of CBS Sunday Morning; died of SLE complications in 1997
• Lady Gaga, has been tested borderline positive for SLE; says she hopes to avoid symptoms by maintaining a healthy lifestyle
• Ferdinand Marcos, former Philippine president; died of SLE complications in 1989
• Mary Elizabeth McDonough, American actress; believes her SLE to be due to silicone breast implants
• Flannery O'Connor, American fiction writer; died of SLE complications in 1964
• Tim Raines, former major league baseball player
• Mercedes Scelba-Shorte, America's Next Top Model Season Two runner-up and model
• Lucy Vodden, inspiration for the Beatles song "Lucy in the Sky with Diamonds"; since becoming aware of this, Julian Lennon has campaigned to raise awareness of lupus
• Ray Walston, character actor who died of SLE complications in 2001 after a six-year battle with the disease
• Michael Wayne, Hollywood director and producer; part owner of Batjac Productions; son of John Wayne, died of heart failure resulting from SLE complications in 2003

References

-- Jytdog (talk) 22:46, 24 August 2017 (UTC)

I think these lists are very doubtful and people should only be mentioned if there is evidence that their illness has influenced popular perception of a particular condition. JFW | T@lk 13:41, 25 August 2017 (UTC)

BSR guideline

doi:10.1093/rheumatology/kex286 (free and probably excellent MEDRS) JFW | T@lk 11:34, 27 October 2017 (UTC)

Semi-protected edit request on 20 February 2018

It is common to have an autoimmune disease while another is present. (Lupus Foundation) Kia82 (talk) 14:53, 20 February 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. —KuyaBriBri^Talk 15:13, 20 February 2018 (UTC)

Werewolves etc?

The section towards the end- History- Modern Period -that discusses ancient descriptions of porphyria as like being a werewolf seem to be irrelevent on this page. Nothing in the paragraph itself says that Lupus symptoms have had this history, but I cannot read the reference. Either we need to edit the paragraph if the reference makes it clear that Lupus symptoms might also be a source of Werewolf legend or we remove it.

IceDragon64 (talk) 01:00, 2 November 2018 (UTC)

Environmental

Environmental redirects to Biophysical environment. The link in the article ("Environmental factors") would be better as "Environmental factors", per MOS:SPECIFICLINK. 62.165.227.157 (talk) 07:03, 9 January 2019 (UTC)

 Done Ruslik_Zero 10:39, 9 January 2019 (UTC)

Epidemiology

As SLE is associated with female sex hormones, the use of such hormones in meat production in the USA might be investigated as possible relation to the 7fold increase of SLE in the US between 1955 and 1974.

As SLE pain is treated with opioids the prescription opioid abuse in the US during the 201xs might be related to the use of hormones in meat production.64.47.214.68 (talk) 08:41, 9 April 2019 (UTC)

Semi-protected edit request on 22 April 2019

In the research category for the SLE page, add in information related to two new research options for treatment and potential cures

1. Potential cure using an existing, approved-for-humans treatment for blood cancers that has cured Lupus in Mice Models. (Source: https://www.sciencemag.org/news/2019/03/genetically-engineered-immune-cells-wipe-out-lupus-mice) 2. Controlling symptoms using an antibody to generate T-Cells responsible for controlling inflammation processes. (Source: https://pipelinereview.com/index.php/2019032070794/Antibodies/Aptevo-Therapeutics-Begins-Phase-1-Clinical-Trial-of-APVO210-a-Novel-Bispecific-Antibody-for-the-Treatment-of-Autoimmune-and-Inflammatory-Diseases.html) Sleacct (talk) 20:48, 22 April 2019 (UTC)

Super early research. Can add a line. Doc James (talk · contribs · email) 15:34, 8 May 2019 (UTC)

Ethnic frequencies

http://www.lupusny.org/about-lupus/who-gets-lupus

African-American women are three times more likely than Caucasian women to get lupus and develop severe symptoms, with as many as 1 in every 250 affected.

And the disease is two times more prevalent in Asian-American and Latina women than it is in Caucasian women. Women of Native American descent are also disproportionately affected.

The famous Lupus in Minorities: Nature Versus Nurture (LUMINA) study—a large multi-ethnic, multi-regional, and multi-institutional examination of lupus begun in 1993—found that genetic and ethnic factors are more important than socioeconomic ones in influencing disease activity. — Preceding unsigned comment added by Nbauman (talk • contribs) 23:04, 24 August 2015 (UTC)

Treatment: cyclophosphamide

Because of potential side-effects, cyclophosphamide (CYC) is used in early phases of treatment for severe cases and substituted with other medications for maintenance therapy.

References

— Preceding unsigned comment added by Winelibrarian (talk • contribs) 15:55, 17 January 2019 (UTC)

Treatment option clarification

Treatment option clarification: following "There is no cure for SLE.[1] Treatments may include NSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, and methotrexate.[1]"

insert: Corticosteroids is one of the most effective therapies resulting in immediate mitigation of inflammation. Long term use of corticosteroids results in significant side-effects. --Swozingram (talk) 23:03, 19 September 2019 (UTC)

Okay ref says "CSs are one of the most effective therapies for immediately dampening inflammation; however, long-term use of CSs can cause serious side-effects"

Will add but paraphrase more.

Doc James (talk · contribs · email) 00:17, 20 September 2019 (UTC)

References

Semi-protected edit request on 12 October 2019

Please add "Making it harder to fight off disease." after "Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body.[1]" Add "The rash on the face is referred to as the butterfly rash." after Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face.[1]" Lastly, add "These flare ups can range from mild, moderate, or severe. “A mild flare can be rash, fatigue, and muscle pain. Severe flares can lead to organ damage including “fluid buildup around the heart or even kidney disease or failure (called lupus nephritis), which would require immediate medical attention.” A symptom of a mild flare can be rash, fatigue, and muscle pain. Severe flares can lead to organ damage including “fluid buildup around the heart or even kidney disease or failure." after "Often there are periods of illness, called flares, and periods of remission during which there are few symptoms.[1]" Cappyhunt (talk) 20:09, 12 October 2019 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. OhKayeSierra (talk) 01:17, 13 October 2019 (UTC)

References

Requested move 2 April 2020

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: Moved. There's consensus for move. (non-admin closure) – Ammarpad (talk) 16:36, 10 April 2020 (UTC)

---

Result of moving Candidal vulvovaginitis to Vaginal yeast infection. Moving medical topics to the WP:COMMONNAME helps people find the health information they need.

Systemic lupus erythematosus → Lupus – This article is impossible to find due to its title. If you search for "lupus" on Google, this page doesn't show up anywhere in the first 20 pages of results! Even Encyclopedia Britannica beats us. All the other major medical sites understand the importance of making their content easily findable by people who are not doctors:

• Mayo Clinic - "Lupus"
• MedlinePlus - "Lupus"
• WebMD - "Lupus"
• Healthline - "Lupus"
• John Hopkins Medicine - "Lupus"
• Health.com - "Lupus"
• Stanford Health Care - "Lupus (Systemic Lupus Erythematosus)"

The only other major website I could find that favors our title is the National Institutes of Health, which uses "Systemic Lupus Erythematosus (Lupus)". For those who will inevitably argue that medical topics on Wikipedia must have exact, unambiguous titles, who exactly does that help? The 1% of viewers who are medical professionals? Even they are likely searching Google for "lupus". Kaldari (talk) 01:56, 2 April 2020 (UTC)

• Support per nom. It's not Lupus. But it should be. That said, I don't at all see the value of the chart given by nom... search engines adjust to our renames fairly quickly, and generally deliver people to the right page more based on keywords and context and not title - there is generally almost no change in views pre- and post-move. -- Netoholic @ 20:57, 2 April 2020 (UTC)

Surely the chart illustrates the opposite of what you assert? That views (at least in this case) changed very significantly pre- and post-move?

• Support I think it reflects common usage and, as with other articles in this situation, a hatnote that points to a disambiguation page will suffice. --Tom (LT) (talk) 06:25, 3 April 2020 (UTC)
• Comment - came here from [[6]].

Lupus (disambiguation) was moved to Lupus by User:Commander Keane in 2006, and in 2010 User:Propaniac moved it back, and redirected Lupus here.

Lupus erythematosus is also a relevant page.

It looks to me that we should move Lupus (disambiguation) back to Lupus, as we should be offering readers a choice on this one.

All the best: Rich Farmbrough (the apparently calm and reasonable) 13:56, 3 April 2020 (UTC).

BTW we are sixth, well above Britannica when I Google. All the best: Rich Farmbrough (the apparently calm and reasonable) 21:09, 3 April 2020 (UTC).

@Rich Farmbrough: You are correct about that. I'm not sure why we were missing before, but I double-checked it before I created the nomination (as it seemed quite strange even given our current title). Thanks for bringing this to my attention. I've struck that part of the move nomination. Kaldari (talk) 14:57, 6 April 2020 (UTC)

• Support. The fascination with "correct" names is ridiculous when not even doctors use the "correct" name. Lupus is fine. Red Slash 22:59, 4 April 2020 (UTC)
• Support per nom.--Ortizesp (talk) 04:39, 5 April 2020 (UTC)
• Support per nom. Captainllama (talk) 00:25, 6 April 2020 (UTC)

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The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Cystisc lung

The article has a concern on the lung disease. As of 2009, the cystic lung disease in association with systemic lupus erythematosus was an extramely rare event recorded in the medical literature. The origin of the cystic lung was unclear. — Preceding unsigned comment added by 78.14.139.120 (talk) 16:37, 30 August 2020 (UTC)

Semi-protected edit request on 26 November 2021

Addition to Reproductive Subsection

Additionally, a common lupus treatment, known as cyclophosphamide (Cytoxan), can lead to infertility by causing [[Primary ovarian insufficiency |premature ovarian insufficiency]] (POI), the loss of normal function of one’s ovaries prior to age forty. <ref>https://www.lupus.org/resources/womens-health-and-reproductive-issues-with-lupus<ref>

Addition to Heart Subsection

Steroids are sometimes prescribed as an anti-inflammatory treatment for lupus; however, this can increase one’s risk for heart disease, high cholesterol, and atherosclerosis. <ref>https://www.hopkinslupus.org/lupus-treatment/lupus-medications/steroids/<ref> 2600:1700:D250:BED0:15AC:EAAE:F125:D692 (talk) 22:47, 26 November 2021 (UTC)

 Done. Heartmusic678 (talk) 16:14, 1 December 2021 (UTC)

Semi-protected edit request on 13 October 2022

Change the line "Those of African, Caribbean, and Chinese descent are at higher risk than white people.[4][2]" to "Those of African, Caribbean, and Chinese descent are at higher risk than those of European descent.[4][2]"

The current wording is inconsistent, comparing geographical / ethnic backgrounds on one hand to skin colour on the other. Matthall nz (talk) 03:07, 13 October 2022 (UTC)

Semi-protected edit request on 15 November 2022

Change X to Y X: Life expectancy is lower among people with SLE.[7] Y: With the rapidly expanding treatment options for symptoms, and knowledge of this disease, life expectancy for 80-90% of patients with SLE aligns with the normal life span. Source: • Lupus.org o URL: https://www.lupus.org/resources/prognosis-and-life-expectancy#:~:text=With%20close%20follow-up%20and,live%20a%20normal%20life%20span. o Medically reviewed on July 18. 2013

The reason why I chose to change the life span sentence is to clarify that treatment can cause the prevention of premature death. The sentence previously was a bit discouraging, especially if someone is reading this page and is recently diagnosed with Lupus. I changed this sentence to show that there is factual and scientific-based evidence that there is hope to live a full life thanks to modern treatments and disease knowledge. Vanderbiltstudent2022 (talk) 03:21, 15 November 2022 (UTC)

 Done I have added a modified version of your suggestion, keep in mind that article content is best kept brief and objective. More concerningly, I could not verify the statement on the 15-year survival rate in the given source, so that content has been removed. Notwithstanding the fact that your suggestion was implemented, your argumentation is not relevant. The potential emotional impact of a sentence is very rarely a relevant consideration on Wikipedia, as the goal is to report on the subject matter as neutrally and objectively as possible. This is especially the case with sensitive subjects such as medicine and potentially disturbing subjects such as wars. Wikipedia is never censored, and in reporting the effects of a disease, some disheartening or potentially upsetting content is necessitated by our commitment to factual accuracy. Actualcpscm (talk) 21:56, 16 November 2022 (UTC)

The “Famous Cases” tab

Considering there’s already an entire page of the list of people with lupus, it seems redundant to have another list on this page. ParentiParrot (talk) 01:36, 29 January 2023 (UTC)