Dr. Susan Manzi: Unmasking The Great Impersonator

Lupus is one of 80 known autoimmune disorders, which affect the body's system of specialized cells and organs that defend against germs. Diagnosis is an art, not a science—with no single blood test available to make the diagnosis certain.



“We think of our patients as snowflakes,” says Dr. Susan Manzi. “No two are alike.”

Photo by Jim Judkis

(page 1 of 3)

When Curtis Nugent’s knees began to ache, the athletic 19-year-old shrugged: too much basketball, thought the freshman at Robert Morris University, assuming the joint pain would subside. He didn’t know it was the first shot in his body’s war with its immune system.

His organs began a seven-month free fall. His kidney function crashed, and he was rushed to UPMC Presbyterian Hospital in April 2005. The diagnosis astonished his family: It was systemic lupus erythematosus (SLE)—often referred to simply as lupus, an autoimmune disease that affects more than 1.5 million Americans.

Nugent had a highly unusual case of a complex disease within a little-understood field; more than 50 million Americans suffer from autoimmune diseases, including Crohn’s disease and multiple sclerosis. Lupus, in particular, presents itself in so many different ways—from heart problems to skin rashes and arthritis—making diagnosis difficult.

The disease is rare in men, who comprise only 10 percent of patients. It is far more common in young women, striking Hispanics, Asians and African-Americans in particular. Symptoms may subside and reoccur over decades, and there is no cure.

“Lupus affects a lot more people than people realize,” says Nugent, now a 24-year-old elementary school teacher in the Wilmington School District. “I was fortunate it was caught in time. I’ve heard other stories—people don’t catch it in time, then need transplants or dialysis. Lupus hides itself so well it looks like other diseases. It’s hard to diagnose.”

His early diagnosis came from Dr. Susan Manzi, one of a limited number of lupologists worldwide. To Manzi, chair of the Department of Medicine at West Penn Allegheny Health System and director of its Lupus Center of Excellence, the bewildering disease is not just a professional specialty—it’s a personal mission.
 

Patients Are 'Like Snowflakes'

Fifty-one-year-old Manzi chose her specialty shortly after graduation from the University of Pittsburgh Medical School while completing a residency in internal medicine at Duke University. “I’ve spent 23 years focused on this disease,” says the Wexford resident—first at the University of Pittsburgh Medical Center and for the past 14 months at West Penn Allegheny. “I couldn’t be more passionate.”

Lupus is often called “The Great Impersonator,” mimicking indicators of other illnesses. Diagnosis is an art, not a science—with no single blood test available to make the diagnosis certain. Treatment has relied on therapies borrowed from other diseases, such as chemotherapy and drugs used to prevent organ-transplant rejection. “We think of our patients as snowflakes,” says Manzi. “No two are alike.”

But Manzi and her colleagues are cheering the recent approval of the first new lupus drug to be developed since 1955. The team at the Allegheny Singer Research Institute, the research arm of West Penn Allegheny, helped design the trial for the new monoclonal antibody, dubbed Benlysta, in which her patients participated.

Benlysta suppresses a protein known as B-lymphocyte stimulator, or BLyS. Elevated levels of BLyS stimulate the body’s production of autoantibodies, which attack healthy tissues.

Manzi calls the resulting process “self-sabotage.” The research challenge, she says, is: “Why would that happen in an otherwise healthy 20-year-old and change her life? You have to know every aspect of medicine—brain, kidney, skin—to treat lupus. It’s a comprehensive disease that is best managed by a team of specialists.”
 

Edit Module

Edit ModuleShow Tags

Hot Reads

Chuck Noll: A Man for All Seasons

Chuck Noll: A Man for All Seasons

Two years after Chuck Noll’s death, University of Pittsburgh Press prepares to publish the first definitive biography of the legendary Pittsburgh Steelers coach. Pittsburgh Magazine is proud to share an interview with author Michael MacCambridge and an exclusive excerpt of “Chuck Noll: His Life’s Work,” scheduled for release in October.
The Changing Face of Campus in Pittsburgh

The Changing Face of Campus in Pittsburgh

Renovation is under way at nearly all of our area colleges and universities. For students heading back to school this fall — and their parents — we offer this crash course on the highlights of these projects and their projected benefits.
Fall Fashion: In the Black

Fall Fashion: In the Black

The little black dress, and shirt, and pants, never go out of style. Add mystery to your wardrobe with these easy-to-accent autumn staples.
Apteka: A Taste of Home

Apteka: A Taste of Home

Kate Lasky and Tomasz Skowronski bring top-notch vegan, eastern European cuisine to Bloomfield.
Edit ModuleShow Tags

The 412

Southwest Airlines Planning More Flights from Pittsburgh

Southwest Airlines Planning More Flights from Pittsburgh

The Allegheny County Airport Authority has been lobbying for more direct service from Pittsburgh to the West Coast.
Zing Basket Promises Speedy Grocery Delivery to Your Door

Zing Basket Promises Speedy Grocery Delivery to Your Door

The online grocery delivery service opened this week, promising delivery in 45 minutes or less to selected neighborhoods.
Old Farmer’s Almanac: Winter in Pittsburgh Will Be Warmer, But…

Old Farmer’s Almanac: Winter in Pittsburgh Will Be Warmer, But…

In its 225th year, the reference book on weather suggests we tune up our snow-removal equipment.
Chris Jamison Releases His First EP

Chris Jamison Releases His First EP

The Ross native finished third on NBC's “The Voice” in December of 2014.

Sign Up for the 412 e-Newsletter

 

Our daily e-newsletter is curated by the editors of Pittsburgh Magazine and is designed to give you the very best Pittsburgh has to offer -- delivered directly to your inbox.

Sign me up!
* Email
 First Name
 Last Name
  * = Required Field
 
Edit ModuleShow Tags
Edit ModuleShow Tags

Hot Reads

Chuck Noll: A Man for All Seasons

Chuck Noll: A Man for All Seasons

Two years after Chuck Noll’s death, University of Pittsburgh Press prepares to publish the first definitive biography of the legendary Pittsburgh Steelers coach. Pittsburgh Magazine is proud to share an interview with author Michael MacCambridge and an exclusive excerpt of “Chuck Noll: His Life’s Work,” scheduled for release in October.
The Changing Face of Campus in Pittsburgh

The Changing Face of Campus in Pittsburgh

Renovation is under way at nearly all of our area colleges and universities. For students heading back to school this fall — and their parents — we offer this crash course on the highlights of these projects and their projected benefits.
Fall Fashion: In the Black

Fall Fashion: In the Black

The little black dress, and shirt, and pants, never go out of style. Add mystery to your wardrobe with these easy-to-accent autumn staples.
Apteka: A Taste of Home

Apteka: A Taste of Home

Kate Lasky and Tomasz Skowronski bring top-notch vegan, eastern European cuisine to Bloomfield.
Talk of The Tahn: City of Beer

Talk of The Tahn: City of Beer

There are plans afoot for a international museum of beer to be built and staffed right here in Pittsburgh.
Pitt vs Penn State: Resumption of Hostilities

Pitt vs Penn State: Resumption of Hostilities

After an extended hiatus, the storied rivalry between the Pitt Panthers and Penn State Nittany Lions returns in September to Heinz Field.
Edit Module

Edit Module

Edit ModuleShow Tags

On the Blogs


Southwest Airlines Planning More Flights from Pittsburgh

Southwest Airlines Planning More Flights from Pittsburgh

The Allegheny County Airport Authority has been lobbying for more direct service from Pittsburgh to the West Coast.

Comments


Pittsburgh, only cooler
PittGirl: How You Should Grade A Squishy Tongue

PittGirl: How You Should Grade A Squishy Tongue

Kennywood Park opens soon and new this season is the return of the famed whale at the entrance of Noah’s Ark. In the name of science, PittGirl paid an early visit to test the squishiness quotient of the whale's all-important tongue.

Comments


All the foodie news that's fit to blog
Where to Go at the Three Day Blow

Where to Go at the Three Day Blow

Our dining critic (and Three Day Blow organizing committee member) has a roundup of some open to the public events.

Comments


Not just good stuff. Great stuff.
The 5 Best Comic Shops in Pittsburgh

The 5 Best Comic Shops in Pittsburgh

These comic book shops offer more than just your casual Batman or Spider-Man choices.

Comments


New Industry Public House Location Up to Par

New Industry Public House Location Up to Par

If you’re in need of a dining option that’s not a national chain while visiting the Robinson area, this is one to keep in mind.

Comments


Mike Prisuta's Sports Section

A weekly look at the games people are playing and the people who are playing them.
Le'Veon Bell Talks The Talk But Can’t Walk The Walk

Le'Veon Bell Talks The Talk But Can’t Walk The Walk

The Steelers running back emphasized his latest suspension resulted from missed random drug tests, and not a relapse into the marijuana-induced haze that got him jammed up last season. But if you lack the maturity to grasp the consequences of your actions (or, in this case, inactions), does it really matter?

Comments


Style. Design. Goods. Hide your credit card.
Custom Made: The Surmesur Suit

Custom Made: The Surmesur Suit

Straight out of Canada, the custom menswear store opens its first U.S. location in Pittsburgh.

Comments


Sean Collier's Popcorn for Dinner

The movies that are playing in Pittsburgh –– and, more importantly, whether or not they're worth your time.
'Hands of Stone' Keeps the Boxing Movie Genre Strong

'Hands of Stone' Keeps the Boxing Movie Genre Strong

Reviews of "Hands of Stone" and "Don't Breathe," plus local movie news and notes.

Comments


Everything you need to know about getting married in Pittsburgh today.
The Lucky Ones: Katie Doré and John Potter

The Lucky Ones: Katie Doré and John Potter

Want even more Real Pittsburgh Weddings? We'll be bringing them to you throughout the fall, beginning with this lovely and lucky couple.

Comments


The latest tips and trends to refresh your home.
Put a Lid On It! The Container Store Coming to Pittsburgh

Put a Lid On It! The Container Store Coming to Pittsburgh

The store famous for carrying storage and organizational products is set to open at the revamped Block Northway in Ross Township.

Comments


The hottest topics in higher education
Two Events Planned for Prospective Waynesburg Students

Two Events Planned for Prospective Waynesburg Students

A fall visitation day and a Saturday information session aim to allow interested students a look into life at the university.

Comments