Ever wondered why Dr. House and his staff suspect Lupus so frequently? Until this week, I always considered that to be very odd, and probably a quirk of the script-writers. Until we learned about Lupus!
Systemic lupus erythematosus (SLE) is an autoimmune disease of the connective tissue. ‘Autoimmune’ means that it occurs when a dysfunction in your immune system causes your immune cells to start reacting against your own body. Essentially, your body starts fighting itself. There are many different autoimmune disorders, but in SLE, the attack is mounted against components of connective tissue. Unfortunately, connective tissue is found virtually everywhere in your body. This means that SLE can affect virtually any organ system.
Seriously – you should see my textbook, and all of the hundred presentations of lupus that are listed there. It is understandable then, that given a systemic disease involving multiple organ systems, you might reasonably suspect lupus.
As you saw in the clip, there’s a sensitive blood test available for lupus: ANA. The clip explains how 95% of people with lupus are positive for ANA, which means that a negative ANA is a sufficiently good indication that you don’t have lupus. The problem occurs when your ANA is positive! Because although the test is sensitive, it’s not very specific and so a few different conditions may present with a postive ANA. So when the ANA is positive, you still have some sleuthing to do… or should I say Dr-House-ing.
I’m confused at your post, Jason Booy.
I’m not really sure what an airline operator has to do with my immune system… Although I must say, they have excellent service!
Comment by Matt — February 5, 2009 @ 7:05 pm
Ha ha
… well in this case ANA = antinuclear antibodies, not the Japanese airline.
Comment by Jason Booy — February 5, 2009 @ 7:36 pm
It’s NOT LUPUS!!!!!!
haha… this just made my anti-social,been-in-my-room-for-hours-studying-super-hard day much better!
I can only imagine the immense amount of work it is to figure out the right diagnosis for patients with multiple-organ failure. So many things in our bodies are connected that rarely you observe a disease being targeted to a single area. It’s the task of diagnosticians-like House and his team-to come up with a reasonable answer to the diagnosis dilemma but many of times, Lupus poses a threat to the proper diagnosis of a condition exhibiting multiple-organ failure just because it sounds like the most correct and comforting answer; an answer that covers all basis; yet an answer that just wouldn’t cut it for House. That’s why I love House. Even though some observations and results point at Lupus as the sole cause for a certain condition (including a positive ANA result), House chooses to go beyond and check for any other possibility, no matter how far-fetched it could be.
Unrealistic? Perhaps, but it does bring the point home. Doctors should not rest until the real cause for a complex condition is found, no matter how appealing it is to say “it’s Lupus”.
(sometimes it just is though!)
Comment by D — February 8, 2009 @ 7:19 pm
I have Lupus (no, seriously, I really do) and that clip was hilarious. Thanks for sharing that. Leslie
Comment by Leslie — February 16, 2009 @ 4:49 pm