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LUPUS AND PARVOVIRUS B19

The disease, lupus, may be caused by infection with parvovirus B19 (1,7) and other viruses or bacteria. When doctors can't find a cause for a disease, they often say that it is autoimmune which means that cells and proteins that are supposed to seek out and kill germs, start to attack and destroy blood vessels throughout the body. Lupus can start as a rash on the face which worsens with exposure to sunlight or it can cause hair loss, joint and muscle pains or it can even damage the heart, lungs, liver, intestines and kidneys. Doctors screen for this disease with a blood test called antinuclear antibody, but 92% of the positive tests occur in people who do not have lupus. Women are far more likely than men to suffer from lupus because the female hormone, estrogen, worsens the disease, while the male hormone, testosterone, helps to prevent it. Even though the vast majority of people with lupus are women, there is no evidence that estrogen worsens lupus in postmenopausal women (2).

Until recently, there were very few papers investigating whether lupus is caused by infection. A recent report shows that parvovirus B19 may be the cause of some cases of lupus (1,7). Other papers show infection with mycoplasma penetrans. Most doctors do not treat lupus until a person has symptoms or shows evidence of kidney damage. They usually start treatment to suppress immunity with prednisone or chloroquine only after a patient shows evidence that her kidneys are being damaged. Recent reports show that a hormone produced by the adrenal glands, called DHEA, may be safer and as effective in controlling lupus as prednisone (3,4,5). We await future research. Although you can buy DHEA across the counter without a prescription, the treatment for lupus should be supervised by a doctor. To keep your immunity from attacking and destroying your own tissues, you must receive a dose high enough to protect you and not so high that it raises blood pressure or limits your immunity. In the mid-1980s, the Food and Drug Administration found that several products marketed as DHEA contained little or no DHEA.

1) P Roblot, F Roblot, A Ramassamy, B Becqgiraudon. Lupus syndrome after parvovirus B19 infection. Revue du Rhumatisme 64: 12 (DEC 1997):849-851.

2) MB Urowitz. Hormone replacement therapy in systemic lupus erythematosus. Journal of Rheumatology 24: 11 (NOV 1997):2149-2152.

3) N Suzuki, T Suzuki, T Sakane Hormones and lupus: Defective dehydroepiandrosterone activity induces impaired interleukin-2 activity of T lymphocytes in patients with systemic lupus erythematosus. Annales de Medecine Interne 147:4(1996):248-252. Low DHEA activity in the serum, and that supplementation of DHEA could improve clinical manifestations in patients with SLE.

4) RW Mcmurray. Prolactin and systemic lupus erythematosus. Annales de Medecine Interne 147: 4 (1996):253-258.

5) T Robinson, CM Neuwelt. Neuropsychiatric lupus and hormones. Annales de Medecine Interne 147: 4 (1996):276-280. Investigational therapy with dehydroepiandrosterone (DHEA) appeared to have benefits with respect to milder symptoms of NPSLE.

6) M Incaprera, L Rindi, A Bazzichi, C Garzelli. Potential role of the Epstein-Barr virus in systemic lupus erythematosus autoimmunity. Clinical and Experimental Rheumatology. 16: 3(MAY-JUN 1998):289-294.

7) A Tanaka, A Sugawara, K Sawai, T Kuwahara. Human parvovirus B19 infection resembling systemic lupus erythematosus. Internal Medicine 37: 8 (AUG 1998):708-710.

8) NN Barry, JL Mcguire, RF Vanvollenhoven. Dehydroepiandrosterone in systemic lupus erythematosus: Relationship between dosage, serum levels, and clinical response. Journal of Rheumatology 25: 12 (DEC 1998):2352-2356. No relationship between bld levels and dose.

9) A Yanez, L Cedillo, O Neyrolles, E Alonso, MC Prevost, J Rojas, HL Watson, A Blanchard, GH Cassell. Mycoplasma penetrans bacteremia and primary antiphospholipid syndrome.. 10)J Langgartner, T Andus, A Hemauer, J Scholmerich, B Lang.Paravirus B19 infection imitating an acute exacerbation of systemic lupus erythematodes. Deutsche Medizinische Wochenschrift, 1999, Vol 124, Iss 28-29, pp 859-862.

10) A Hemauer, K Beckenlehner, H Wolf, B Lang, S Modrow.Acute parvovirus B19 infection in connection with a flare of systemic lupus erythematodes in a female patient.Journal of Clinical Virology, 1999, Vol 14, Iss 1, pp 73-77

Checked 8/9/05

May 29th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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