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August 1960

What Is Systemic Lupus?Some Comments on Its Pathogenesis and Course

Arch Intern Med. 1960;106(2):162-167. doi:10.1001/archinte.1960.03820020002002

Systemic lupus erythematosus (S.L.E.) has been a mysterious disease since it was first recognized as an entity years ago.1 At first thought to be a "toxic" disturbance, later an infection closely related to tuberculosis, it was eventually placed in the category of the "collagen disorders." This was considered a group of disturbances characterized by a seeming lack of etiologic factors, a diversity of manifestations, and histologically, by a presumed generalized disturbance of collagen.3 To explain the latter finding, a rather vaguely defined hypersensitivity mechanism was invoked in some quarters.4 However, this was primarily the era of the histopathologist, and only in retrospect can one see now that the highly significant discovery of the L.E. phenomenon 5 represented a break from the morphologic approach to the predominantly immunologic.

The possibility that the L.E. factor in the serum could be immunologic in nature was rather slow in developing, but