Category Archives: It’s not Lupus except when it is
Alaina Szocik (5 PM Micro) thinks perhaps I’m being narrow-minded in only putting “House, MD” up here for dissection. She wants to discuss “Private Practice,” and thinks that if I’d just give it a chance, that I’d be a convert as. Well Alaina, “House” is on at 9 PM, and “Private Practice” is on at 10; when you get old like me, bedtime is a bit earlier than it is for you kids. Here is Alaina’s extraction of the medical mystery out from the drama of the episode:
Could it be lupus? Well in this case, yes it seems to be. Private Practice, the popular medical drama on ABC, included a section of the show on Thursday, November 17th, that consisted of a young male patient, having systemic lupus erythematosus. As the boy came into the office, Cooper, the show’s pediatrician, began palpating his abdomen. The boy’s father stated he had sharp stomach pains, and had spiked a high fever. It was also obvious that the boy had a butterfly rash on his face, a very noticeable sign of the redness of skin caused by lupus. In addition, when exiting the doctor’s office, the boy had a sudden, rather intense nose bleed.
At the next scene, Cooper informed the boy’s father of the diagnosis. He stated the boy was experiencing liver failure, and after he did a liver biopsy to get a blood count, he concluded that the lupus had trigged an autoimmune condition where the immune cells were attacking his own body cells. Cooper then insisted that the boy needed a stem cell transplant. After the transplant, I noticed the butterfly rash was no longer present.
The signs and symptoms that the show presented all describe the Type III immune complex mediated hypersensitivity of systemic lupus erythematosus. As learned in class, and from the textbook, we know this is due to the body’s immune system forming antibodies against normal antigens on our cells. The textbook states, “it affects different organs throughout the body”; which explains why the boy was having sharp pains throughout his abdominal area, and failure to his liver. Also, the bloody nose illustrates another side effect of the autoantibodies; as stated in the text, they cause the blood platelets to “give rise to bleeding disorders”. The sudden high fever as we have also learned was from the pyrogenic factors of the antigen-antibody complexes, which trigged the hypothalamus to reset its temperature, to aid in the body’s defense. And finally, as soon as I saw the butterfly rash, I yelled to my mother “ITS LUPUS!”, and sure enough I was correct, and I have to give credit to the information learned in microbiology.
The most common treatment for lupus involves drugs to help reduce inflammation because of the autoimmune complexes built up in the body. In this episode instead they do a stem cell transplant to give the body new hematopoietic stem cells that will differentiate and hopefully overcome the immune complexes. As we also learned in class, these stem cells can form into any blood cells in the body such as erythrocytes, leukocytes, and lymphocytes.
So maybe after this episode Dr. Singleton can begin to have an interest or appreciation for Private Practice? Ok so maybe it did not necessarily show enough scientific evidence for diagnosing lupus, however; it did provide a lot of educational connections to be made with what has been learned so far throughout microbiology, and shows that it is important to have a basis of knowledge on how the body fights and reacts to different pathogens and diseases. You never know when it’s going to used!