LUPUS

Lupus erythematosus (LE) is a generalized inflammatory disease induced by poorly functioning T cells (part of the white blood cell family).

The cause of LE is unknown. It is a type of autoimmune disease and affects many organs in the body. Approximately 90 percent of individuals with LE are female. Onset is usually found between ages 20 to 45. With lupus, the damage to various organs is caused by the immune complexes being deposited in the tissues.

There are five forms of LE; Systemic LE (SLE), which occurs in 75 percent of lupus sufferers, has the most serious outcome. Painful joints may include avascular necrosis of the femoral head, which is the destruction of the end of the femur due to poor blood flow. This occurs in 90 percent of cases.

Fevers, malaise, a typical "butterfly rash" or other skin problems are common. Heart lesions are common but they may not cause obvious disease.

The lungs and kidneys are also affected by LE. Lung damage and fibrosis occur in 50 percent of lupus cases. Lupus can affect the central nervous system, causing stroke and nerve palsies or weakness. Drug-induced LE may be short-lived, however, and it usually has minimal lasting effects.

Fitness and Diving:
Due to the multiple areas of damage from LE, diving is not recommended for anyone with any form of the disease. Confusion with symptoms of DCI and problems of fitness can arise, and the poor function of heart and lungs make diving inadvisable. In such a wide-ranging disease, all body systems can be affected before observable symptoms appear.

Medication Used in Treatment: Drugs that may be used to treat an LE type diagnosis include isoniazid, procainamide and hydralazine.

Treatment by numerous drugs include:
Sunscreens for photosensitive rashes, steroid creams for skin lesions and oral steroids for more severe disease.
Aspirin and NSAIDs (like ibuprofen) may decrease pain. Antimalarials such as chloroquine or low-dose steroids are used for severe skin problems. The cytotoxics cyclophosphamide and azathioprine have also been used.

Additional Information:
The following websites have excellent information from which this summary was made, notably: The American Liver Foundation- http://gi.ucsf.edu/alf.html
The Canadian Hepatitis Information Network- http://www.hepnet.com/

(Guy De Lisle Dear MD, Alert Diver, Sept-Oct 1999.)