The History and Study of Lupus

Lupus is a systemic autoimmune disease that occurs when the body attacks it’s own organs and tissues. The condition can be very difficult to diagnose as symptoms can mimic those of other illnesses. As such patients are often misdiagnosed. In some the symptoms come on suddenly, and in others they develop slowly over a longer period of time. These symptoms can be temporary, permanent, or occur as frequent ‘flare ups’. The most recognisable symptom is the rash that spreads over the nose and cheeks in the shape of a butterfly’s wings. No two cases are alike however, and common symptoms include fatigue, fever, joint pain, stiffness or swelling, confusion, or memory loss, headaches, photosensitivity, raynauds, shortness of breath and chest pain.

The study and recognition of Lupus stretches as far back as Hippocrates, from whom the term “Hippocratic oath” originated. Hippocrates wrote about the severe red facial rash which we now recognise as a symptom of Lupus. It is believed that the term, which is Latin for “wolf” was coined by the physician Rogerius in the 1200s. The term was used to describe the  facial lesions, as it was said that they resembled a wolf attack, or even the faces of wolves themselves.

Very little was known about Lupus until research began in earnest in the 1800s. The revolution in the understanding of medicine and pathology, not least spurred by the new interest in anatomy and dissection as an attempt to understand the functioning of the body, prompted research into the disease. In the mid 19th century Viennese physicians Ferdinand von Hebra and his son in law Moritz Kaposi wrote the first treatises recognising that the symptoms of Lupus extended beyond the skin and could affect the organs and tissues of the body. It wasn’t until 1851 that the term “Lupus Erythematosus” was first used by the French physician Pierre  Cozenave, combining the word “Lupus”, ie “wolf”, with the Greek word for “redness”. The first treatises on Lupus Erythematosus was written between 1895 and 1903 by Canadian physician Sir William Osler, stating that the central nervous system, muscles, skeleton, heart and lungs could be affected by the disease also. It was also the first study stating that it could flare up and plateau, rather than being consistent.

Dr Motirz Kaposi. one of the doctors instrumental in our modern understanding of Lupus

In 1941 pathologists at Mount Sinai Hospital in New York City wrote a detailed pathological description of the disease. Dr Paul Klemperer coined the phrase “collagen disease” leading to our modern classification of Lupus as an autoimmune disease, or one in which the body attacks it self. The developments of the 40s identified the systemic inflammatory part of the disease and allowed doctors to diagnose it faster and with greater reliability.

In 1949 the newly discovered hormone Cortisone was discovered to be an effective treatment for Lupus. This led to the discovery in the 50s that the disease was part of the ANA (antinuclear antibody) reaction, leading to a series of tests for antibodies that are still used today. This gave rise to further research on antibodies, showing that the blood of Lupus patients have other antibodies present, some of which were found to bind to the DNA itself. This led to the test for the Anti-DNA antibodies themselves, which is still widely used today.