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Smoking Can Trigger Lupus

But study says those who quit reduce their risk of autoimmune disease

THURSDAY, March 4, 2004 (HealthDayNews) -- Smoking can trigger the onset of lupus and quitting can reduce that risk, a new study finds.

"Lupus is a rare disease," says lead researcher Dr. Karen H. Costenbader, a rheumatologist from the division of rheumatology, allergy and immunology at Massachusetts General Hospital. "But we found a small, yet significant, increased risk of developing lupus among current smokers compared with people who never smoked."

However, Costenbader notes that for people who quit the habit, their risk of developing lupus became the same as if they had never smoked.

Lupus is a chronic inflammatory disease affecting various parts of the body, especially the skin, joints, blood, kidneys, lungs, liver, heart and nervous system. According to the Lupus Foundation of America, more than 16,000 Americans develop lupus each year. And it is estimated that 500,000 to 1.5 million Americans have been diagnosed with the disease.

Lupus can occur at any age, and in both men and women, although it occurs 10 to 15 times more frequently in women. Some common symptoms include achy joints, fever, arthritis, prolonged or extreme fatigue, skin rashes and anemia.

While there is no cure for lupus and some people die from the disease, most can live a normal life with treatment.

"There are probably a lot of different things that cause lupus, but genetics is the strongest risk," Costenbader says.

Environmental factors, such as certain drugs, sunlight, exposure to viruses and perhaps even smoking, may cause some kind of stress on the body and trigger lupus in people with a genetic disposition for the disease, Costenbader explains.

Costenbader's team analyzed nine studies that looked at the risk of a type of lupus called systemic lupus erythematosus and smoking.

Among both men and women smokers, the risk of developing lupus was 1.5 times greater compared with nonsmokers, the researchers found.

However, the risk was no greater for ex-smokers than for people who had never smoked, according to the report in the March 4 online issue of Arthritis and Rheumatism.

"For those with a genetic risk of developing lupus, the thing to do is to stop smoking," Costenbader advises.

Dr. Joan T. Merrill, medical director of the Lupus Foundation of America, notes smoking is not a direct cause of lupus.

To get lupus you need a combination of a certain set of genes and a certain environmental trigger, Merrill says. If you have lupus in your family, you have a 5 percent to 12 percent chance of getting the disease.

This latest study may lead to finding reasons why people get lupus, she adds.

"Smoking decreases some of your good immune system balance, and if you have the genetic predisposition to lupus, it makes it a little more likely that you are going to get lupus," Merrill says.

"The study shows that you shouldn't smoke, and if you do, quit. And here's one more reason," she adds.

More information

The Lupus Foundation of America has more information on lupus and the American Lung Association can tell you more about the dangers of smoking.

SOURCES: Karen H. Costenbader, M.D., M.P.H., division of rheumatology, allergy and immunology, Massachusetts General Hospital, and fellow, medicine, Harvard Medical School, Boston; Joan T. Merrill, M.D., head, clinical pharmacology research program, Oklahoma Medical Research Foundation, and medical director, Lupus Foundation of America, Oklahoma City; March 4, 2004, online issue, Arthritis and Rheumatism
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