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Featured Clinical Reviews

May 15, 1981

Witchcraft and Lupus Erythematosus

Author Affiliations

From the Department of Internal Medicine, St John's Hospital, Longview, Wash.

JAMA. 1981;245(19):1937. doi:10.1001/jama.1981.03310440037021

THE SYMPTOMS of systemic lupus erythematosus (SLE) are as numerous as its pharmacologic treatments. Hemolytic anemia, vasculitis, synovitis, lymphadenopathy, nephritis, hepatitis, cerebritis, serositis, and rashes may respond to aspirin, corticosteroids, antimalarial and myelosuppressive alkylating agents, and a plethora of synthetic, nonsteroidal, anti-inflammatory concoctions. Apparently, however, there is another treatment.

Report of a Case  In early 1977, a 28-year-old Philippine-American became ill with weakness, hepatomegaly, and intermittent lymphadenopathy. Two referral clinics documented high ESRs, polyclonal gammopathy, and mild anemia. Also found were RBC and WBC casts and a moderate amount of albumin in her urine. Biopsy specimens of the liver and lymph nodes disclosed non-specific inflammatory changes, and the diagnosis of SLE was established only when antinuclear antibody and lupus erythematosus clot test results (formerly negative) became positive. The anti-DNA level was 68 units/dL (normal, <10 units/dL), and the serum creatinine level was 0.7 mg/dL. Shortly after prednisone therapy, 60 mg/day,

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