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GU Doctor Finds Link Between Autoimmune Disease, Non-Healing Wounds

Dr. Victoria Shanmugam

Georgetown rheumatologist Victoria Shanmugam and her research team discovered that a significant number of patients with non-healing wounds also had an underlying autoimmune disease.

November 07, 2011 – While most people with wounds that don’t heal have diabetes, some may be suffering from autoimmune diseases, according to new research by the Georgetown University Medical Center (GUMC).

Led by Dr. Victoria Shanmugam, a rheumatologist and GUMC assistant professor of medicine, the research will be presented tomorrow at the annual meeting of the American College of Rheumatology in Chicago.

Shanmugam and her research team studied charts at Georgetown University Hospital’s high-volume wound clinic. Of 340 patients treated during a three-month period, 49 percent had diabetes, which she says is a typical rate.

Under-Recognized Link

“But what was surprising is that 23 percent had underlying autoimmune diseases,” she says, “and the connection between these relatively rare disorders and wounds that don’t heal is under-recognized.”

Of the 78 patients with an autoimmune disease, most had rheumatoid arthritis, lupus or livedoid vasculopathy, a type of vascular disease.

Shanmugam hopes her research will make general practitioners more aware of the link between autoimmune disease and non-healing wounds.

“If a doctor has a patient with a leg ulcer that won’t heal after three or four months and they have done all the appropriate treatments, I hope they will look for the presence of an autoimmune disorder,” she says.

“Sometimes a non-healing wound can be the first presenting feature of an autoimmune disease, and unless they are properly evaluated patients will not receive the correct treatment.”

Emotionally, Financially Draining

Shanmugam’s interest in this research began when she noticed that whenever her autoimmune diseases patients had open wounds, those wounds were very slow to heal.

She says these patients’ recovery time was even more protracted than those with diabetes, a disease notoriously damaging to blood vessels and normal skin repair.

The professor says her findings also show that autoimmune disease-associated wounds were significantly larger at the patient’s first visit. These non-healing wounds can be “incredibly emotionally draining and financially costly,” she says.

Georgetown-Howard Center

Sometimes, these wounds turn into infections that lead to surgery and the amputation of limbs. But more often, they require skin grafts or the use of skin substitutes, which may not solve the problem.

Shanmugam’s study found that skin grafts were more likely to fail in patients with autoimmune disease.

The professor’s research is funded by a KL2 Mentored Career Development Program Scholar grant from Georgetown-Howard Universities Center for Clinical & Translational Science.

Established in 2010, the center is funded by a National Institutes of Health Clinical and Translational Science Award. The KL2 grant funds junior faculty members who have started translational research programs.

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