Complications of the autoimmune disease lupus took the life of Alexandra “Sasha” McHale on Nov. 24. She was the daughter of Houston Rockets coach Kevin McHale.
Only 23, she had been hospitalized for two weeks before her death, according to the team. McHale, 54, had been on a leave of absence with his family while her health declined.
Alexandra McHale was a student at the University of Minnesota Duluth and had been diagnosed with systemic lupus erythematosus last year.
“Unfortunately, awareness of this disease is rather low and an event like this suddenly comes up and people think, ‘Oh, my god, a 20-year-old is not supposed to by dying,’” said Dr. Cynthia Aranow
“Unfortunately, despite tremendous advances in research, it is still a life-threatening disease,” she said.
Rockets owner Leslie Alexander released a statement expressing the team’s grief over McHale’s daughter’s death.
“Kevin and Lynn are loving and dedicated parents who will need our continued support throughout this very difficult time,” she wrote. “Our entire organization is mourning the McHal
e family’s loss and we ask that you keep them in your thoughts and prayers.
Alexander did not indicate what the medical complications were in the death.
Lupus is a chronic disease that can damage any part of the body, including the skin, joints and other organs. In lupus, something goes wrong in the immune system, which creates autoantibodies that attack and destroy healthy tissues and causes inflammation and pain.
According to the Lupus Foundation of America, at least 1.5 million Americans have lupus, mostly young women. More than 16,000 new cases are reported annually. The disease can range from mild to life-threatening, but with good medical care, most people can lead a full life.
Women are affected disproportionately — a ratio of
9 to 1 men, according to Aranow. And for women of color, they are affected at three times the rate of Caucasian women.
“The immune system is designed to protect the body from foreign bugs, but loses it ability to tell the difference between the cell and what is foreign and it mounts an attack against the cells,” said Aranow.
In some cases, the disease is mild, with rashes, fatigue and some arthritis. In other cases it can severely affect the body’s major organs.
Complications can include metabolic syndrome, which is characterized by increased waist circumference and elevations in cholesterol, fats in the blood, blood pressure and fasting sugar blood levels. The condition puts a patient at risk for cardiovascular disease, according to the Lupus Foundation.
Another common complication is inflammation of the kidney or lupus nephritis. About half of all people with the disease will develop this within a decade of diagnosis.
According to Dr. H. Michael Belmont, director of the Lupus Clinic Bellevue Hospital, NYU Center for Musculoskeletal Care, death most often occurs in the first 10 years of the diseas
e — about 10 percent of all diagnoses.
“Sadly and unfortunately, it is young patients who can die of the disease, as it affects chiefly women of childbearing age,” he said.
If lupus affects the lungs, there can be “overwhelming” respiratory failure, even with use of medicines intended to reverse inflammation, said Belmont. Kidney inflammation can progress to kidney failure and require dialysis, though it is usually not fatal.
Rarely, lupus can also cause inflammation in the heart or brain.
And because the disease is treated with high doses of steroids, anti-inflammatory and chemotherapy drugs, the immune system can be compromised, lowering the patient’s ability to fight fungal and bacterial infections.
“The fury of the disease is so intense that despite appropriate management, the patient succumbs,” he said.
Still, death is rare, said Belmont.
“The fact is, earlier on, the data was unclear and everyone thought lupus was a death sentence,” he said. “Ninety percent, in fact, go on to do reasonably well.”