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Lack of early diagnosis of Lupus can lead to disability and kidney failure? says Arthritis and Rheumatism Council report. A significant number of Britain's GPs are failing to diagnose a rheumatic disease which attacks between 20 and 30,000 people in the UK, says a report published today by the Arthritis and Rheumatism Council (ARC).

The little known disease Lupus can cause kidney failure, destroy joints, and lead to frequent miscarriage. Nine out of ten sufferers are women, usually of child-bearing age. The medical research charity is so concerned that it is launching a campaign to make OPs more aware of the disease and its symptoms. Misdiagnosis of the condition happens frequently, preventing early treatment and management of the disease - two factors which are both essential for the patient's survival and quality of life, said the ARC, at the launch of its Research Week into Lupus, aimed at highlighting the strides being made into in Lupus research and treatment, to raise awareness of the disease.

"The main reason why so many GPs fail to spot Lupus is because of the chameleon-like nature of the disease, and its ability to mimic other diseases," said Professor David lsenberg, ARC Diamond Jubilee Professor of Rheumatology at Universitv Colle~e London. vere 20 years ago, uch as thinning of uno suppressants, , although Lupus patients followed 55 of dialysis and ups" when the disease starts to attack their organs, then periods of respite. Lupus has to be carefully managed. Treatments are far more successful then they ~ when high dose steroids were mainly prescribed, often with serious side effects 51 the bones (osteoporosis). Today, low dose steroids continue to be used, as well as anti-malarial drugs, imm and the use of low dose Cyclophosphamide for patients with kidney disease.

Better tailoring of existing drugs was a factor for the improvements in treatment remained a disease of considerable mortality, said Prof Isenberg. Out of 200 of his up over 15 years, 24 had died. The average age at the time of death was 43. "The disease is common, for example at our Lupus clinic at St Thomas's, we have more than 2,000 patients on our register, "said Dr Hughes. But, he added, despite the advances of the past decade, Britain had been slow to recognise Lupus as a rheumatic disease compared to the US, and other European countries. Although worldwide Lupus is more common than multiple sclerosis or leukaemia, few people have even heard of it. "The vast majority of people with Lupus are seen by rheumatologists, and the once the disease has been detected, it can be managed through treatment, before irreparable damage has been done," he added.

Lupus is an incurable disease of the immune system, which is caused when the body's defence mechanism goes into overdrive and starts to attack itself. ARC is funding several research projects to the tune of several million pounds in leading centres in London, Sheffield and Birmingham which are trying to establish the antibody structure of the disease, and its underlying genetic components. "From the research point of view, major advances are being made in understanding the immunology and molecular biology of the antibodies associated with Lupus," said Prof Isenberg. Symptoms range from joint and muscle pain, heart problems, ulcers, fever, rashes, frequent miscarriage.

"We are using the same drugs, such as steroids, as we did 20 or 30 years ago, but we know use them more judiciously. These days the most common cause of death is probably infection as a consequence of having been over-treated with immuno suppressives." "But there is no doubt that the earlier it is treated, the better the prognosis. Which is why it is so important that it is diagnosed correcfly." their families.

CARE SERVICES FOR ETHNIC MINORITY CHILDREN MUST BE IMPROVED, SAYS NATIONAL STUDY There are serious question marks over the quality of the care provided for ethnic minority youngsters by social service departments, warns a new report out today. The report, Acting on Principle, is ffie first study to evaluate the implementation by local authorities of the requirement in the 1989 Children Act that they 'give due consideration to the child's religious persuasion, racial origin and cultural and linguistic background'.

For further information or for copies of Acting on Principle please contact: Leigh Chambers at BAAF on 0171 593 2038 (0181 674 1277 evenings) or Chris Myant at the CRE on 0171 932 5380 (0374 813488 mobile)

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