Systemic lupus erythematosus is a chronic, life-threateningdisease that predominantly affects women of childbearing age.Its pathogenesis includes autoantibody-mediated organ damageand antiphospholipid-antibody–mediated hypercoagulability.Among patients who have lupus the incidence of cardiovasculardisease is 10 to 50 times as high as among age-matched controlsubjects. Optimal therapy for lupus would, with acceptable risk,control immune complex–mediated disease, reduce thromboticrisk, retard the progression of atherosclerosis, and reducedependence on corticosteroids. Cyclophosphamide, which is currentlythe mainstay of treatment for severe lupus flares, is associatedwith a high rate of complications, including gonadal failure,infection, and secondary malignant disease. Physicians . . . [Full Text of this Article]
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From the Division of Rheumatology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
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