A Disease with a Thousand Faces

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New study shows that some symptoms of lupus are more likely to occur in groups.
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Lupus is a chronic disease that affects one in a thousand Canadians, primarily young women. Its cause is still unknown and currently there is no cure.

Lupus is commonly known as ‘the disease with a thousand faces’, as it can lead to a wide variety of symptoms and clinical test results that differ from one person to another. Moreover, these features can change over time and often mimic those of other unrelated diseases.

Lupus symptoms can include—but are not limited to—fatigue, joint pain and stiffness, skin rashes, chest pain, fever and kidney failure.

Dr. Zahi Touma, a Krembil Clinician Investigator and a Clinician Scientist with the University of Toronto, recently led a large international study to better understand the relationship among the symptoms and clinical test results associated with lupus. Towards this end, Dr. Touma and his colleagues examined medical records of 389 people diagnosed with lupus from Asia, Europe and the Americas.

The researchers discovered that some features of lupus are more likely to occur together than alone. For example, it is more likely for a lupus patient to have mouth ulcers and skin rash, than to have either symptom alone. Features that tend to occur together often involved the skin, immune system or blood.

“This work was part of a much larger initiative—involving over 100 lupus experts from numerous countries and medical disciplines—that established new criteria to help researchers identify uniform groups of lupus patients for clinical research. These criteria, which were informed by our findings, will make it easier for researchers to reveal the mechanisms underlying lupus and its symptoms, as well as identify new treatments for this complex disease,” says Dr. Touma.

This work was supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR).

Touma Z, Cervera R, Brinks R, Lorenzoni V, Tani C, Hoyer BF, Costenbader KH, Sebastian GD, Navarra SV, Bonfa E, Ramsey-Goldman R, Tedeschi SK, Dörner T, Johnson SR, Aringer M, Mosca M; ACR/EULAR group. Associations among classification criteria items within systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2019 Sep 27. doi: 10.1002/acr.24078.

Dr. Zahi Touma, Krembil Clinician Investigator, Krembil Research Institute.