Itachi's mysterious sickness
Dec. 13th, 2010 08:49 pm![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
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chuunin_archiveBack in August, I started seriously asking myself the question - what disease does Itachi have? When the internet couldn't give me anything better than 'advance-the-plot-itis,' I decided to take matters into my own hands.
After months of intense research, I think it's finally time to give Itachi Uchiha a REAL diagnosis... microscopic polyangiitis.
In short, MPA is a rare form of systemic vasculitis. It is an auto-immune disorder, characterized by antineutrophil cytoplasmic antibodies attacking the small vessels, causing them to bleed as they become damaged and inflamed. It can have far-reaching consequences throughout different organ systems that, when compared to Itachi's mysterious sickness, is nothing short of startling.
The most visible symptom of Itachi's illness is hemoptysis.
The hemoptysis is, more likely than not, a result of diffuse alveolar hemorrhage. This is a classic symptom of MPA when it presents with pulmonary manifestations. There is also shortness of breath, and coughing.
Unlike many other forms of vasculitis, such as wegener granulomatosis for example, the upper respiratory tract is usually spared. All the damage is deeper in the lungs. Itachi's case is consistent with this.
Other symptoms along the same vein can be seen during his final battle with Sasuke when Itachi grabs his shirt, reacting to what appears to be a heart attack.
Chest pain, myocardial infarction and other signs of cardiac failure are not uncommon effects of this disease, especially considering how it presented.
It is also no secret that by the time of his death, Itachi was nearly blind. This, we know, to be a direct result of the mangyeko sharingan. When the mangyeko is used, it clearly puts a tremendous amount of strain on the eye, and the nerves and blood vessels that surround it. Needless to say, it's inflammatory in and of itself. But it is hasty to assume that Itachi's eye problems are caused by the mangyeko alone.
Ocular involvement in MPA is uncommon, but can exist - usually in the form of retinal hemorrhage and scleritis. The bloodshot eyes Itachi sports in his final battle with Sasuke show these symptoms clearly.
And given this, it's no stretch to assume that MPA played a large role in accelerating the damage the mangyeko did to his eyes, hastening his vision loss.
Those are the only clues to Itachi's symptoms given outright in canon. But we can extrapolate others from the way he conducts himself.
His low stamina as reported by the databook suggest constitutional symptoms of malaise and fatigue. The peculiar way he rests one hand in his cloak could be an attempt to alleviate painful sensations attributed to peripheral nervous system involvement manifesting as mononeuritis multiplex or myalgia, or simply to support a weakened limb. One could probably even argue his thin stature is evidence of weight loss.
There are, of course, come classic manifestations of MPA that cannot be observed in Itachi. This, however, dos not mean that they can't be rectified.
One of the most common ways MPA manifests itself is with renal involvement. We have no evidence that Itachi's kidneys have been damaged by disease. However, it is possible the damage is there, and simply did not produce outward, observable symptoms. At least half the cases of MPA also report skin involvement. This can range from small blisters to necrosis and gangrene. There are reports, however, of MPA only causing splinter hemorrhages, or small areas of bleeding under the nails. As the Akatsuki always wear nail polish, this would be completely unobservable.
Long story short, the symptoms fit. In fact, they're pretty much textbook.
Next, we consider what we know about how the disease was managed. Madara describes Itachi's disease to Sasuke in one panel.
There, he reveals that Itachi took a variety of different medicines to keep himself alive. He could easily be describing the treatment of MPA, which requires a combination of different steroids and immunosuppressive agents. Because treating the disease requires suppressing his immune system, Itachi likely needed other drugs as well, including specific types of antibiotics and vitamins. Considering the high mortality rate of untreated microscopic polyanglitis, (a five-year survival rate of under 25%) this really did have the purpose of prolonging his life. Madara did not lie.
Lastly, we consider the prognosis.
The average age of onset is usually in the fifth decade of life, but cases around Itachi's age have been reported in medical literature. The cause of the disease is currently unknown. It is seen as an auto-immune disorder, but because it doesn't have a tendency to run in families, it's not viewed as genetic. (Sasuke, after all, is still healthy.) However, it is theorized that there needs to be a trigger event, such as a disease or a major bout of inflammation that sets the production of antibodies into overdrive. This trigger could easily be the initial, or repeated, activation of the mangyeko sharingan, which as stated before, is clearly inflammatory in and of itself.
The natural course of the disease fits cleanly into the time line of canon events as well. It is conceivable that, in the period of time following the chunin exam arc, he fell victim to the disease in full force. His whereabouts are unknown during the time-skip, where he likely managed to control it through medication, go into remission and then relapse again. That relapse would be the deciding factor in seeking out his final battle with Sasuke. The time between induced remission and relapse is usually around 2 years if it occurs, again fitting nicely with the chronology of the canon universe. And his death at Sasuke's feet is thus, easily explained.
After months of intense research, I think it's finally time to give Itachi Uchiha a REAL diagnosis... microscopic polyangiitis.
In short, MPA is a rare form of systemic vasculitis. It is an auto-immune disorder, characterized by antineutrophil cytoplasmic antibodies attacking the small vessels, causing them to bleed as they become damaged and inflamed. It can have far-reaching consequences throughout different organ systems that, when compared to Itachi's mysterious sickness, is nothing short of startling.
The most visible symptom of Itachi's illness is hemoptysis.
The hemoptysis is, more likely than not, a result of diffuse alveolar hemorrhage. This is a classic symptom of MPA when it presents with pulmonary manifestations. There is also shortness of breath, and coughing.
Unlike many other forms of vasculitis, such as wegener granulomatosis for example, the upper respiratory tract is usually spared. All the damage is deeper in the lungs. Itachi's case is consistent with this.
Other symptoms along the same vein can be seen during his final battle with Sasuke when Itachi grabs his shirt, reacting to what appears to be a heart attack.
Chest pain, myocardial infarction and other signs of cardiac failure are not uncommon effects of this disease, especially considering how it presented.
It is also no secret that by the time of his death, Itachi was nearly blind. This, we know, to be a direct result of the mangyeko sharingan. When the mangyeko is used, it clearly puts a tremendous amount of strain on the eye, and the nerves and blood vessels that surround it. Needless to say, it's inflammatory in and of itself. But it is hasty to assume that Itachi's eye problems are caused by the mangyeko alone.
Ocular involvement in MPA is uncommon, but can exist - usually in the form of retinal hemorrhage and scleritis. The bloodshot eyes Itachi sports in his final battle with Sasuke show these symptoms clearly.
And given this, it's no stretch to assume that MPA played a large role in accelerating the damage the mangyeko did to his eyes, hastening his vision loss.
Those are the only clues to Itachi's symptoms given outright in canon. But we can extrapolate others from the way he conducts himself.
His low stamina as reported by the databook suggest constitutional symptoms of malaise and fatigue. The peculiar way he rests one hand in his cloak could be an attempt to alleviate painful sensations attributed to peripheral nervous system involvement manifesting as mononeuritis multiplex or myalgia, or simply to support a weakened limb. One could probably even argue his thin stature is evidence of weight loss.
There are, of course, come classic manifestations of MPA that cannot be observed in Itachi. This, however, dos not mean that they can't be rectified.
One of the most common ways MPA manifests itself is with renal involvement. We have no evidence that Itachi's kidneys have been damaged by disease. However, it is possible the damage is there, and simply did not produce outward, observable symptoms. At least half the cases of MPA also report skin involvement. This can range from small blisters to necrosis and gangrene. There are reports, however, of MPA only causing splinter hemorrhages, or small areas of bleeding under the nails. As the Akatsuki always wear nail polish, this would be completely unobservable.
Long story short, the symptoms fit. In fact, they're pretty much textbook.
Next, we consider what we know about how the disease was managed. Madara describes Itachi's disease to Sasuke in one panel.
There, he reveals that Itachi took a variety of different medicines to keep himself alive. He could easily be describing the treatment of MPA, which requires a combination of different steroids and immunosuppressive agents. Because treating the disease requires suppressing his immune system, Itachi likely needed other drugs as well, including specific types of antibiotics and vitamins. Considering the high mortality rate of untreated microscopic polyanglitis, (a five-year survival rate of under 25%) this really did have the purpose of prolonging his life. Madara did not lie.
Lastly, we consider the prognosis.
The average age of onset is usually in the fifth decade of life, but cases around Itachi's age have been reported in medical literature. The cause of the disease is currently unknown. It is seen as an auto-immune disorder, but because it doesn't have a tendency to run in families, it's not viewed as genetic. (Sasuke, after all, is still healthy.) However, it is theorized that there needs to be a trigger event, such as a disease or a major bout of inflammation that sets the production of antibodies into overdrive. This trigger could easily be the initial, or repeated, activation of the mangyeko sharingan, which as stated before, is clearly inflammatory in and of itself.
The natural course of the disease fits cleanly into the time line of canon events as well. It is conceivable that, in the period of time following the chunin exam arc, he fell victim to the disease in full force. His whereabouts are unknown during the time-skip, where he likely managed to control it through medication, go into remission and then relapse again. That relapse would be the deciding factor in seeking out his final battle with Sasuke. The time between induced remission and relapse is usually around 2 years if it occurs, again fitting nicely with the chronology of the canon universe. And his death at Sasuke's feet is thus, easily explained.
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no subject
Date: 2010-12-14 03:04 am (UTC)thank you so much again for the informing post! :D
no subject
Date: 2010-12-14 03:05 am (UTC)no subject
Date: 2010-12-14 03:25 am (UTC)no subject
Date: 2010-12-14 03:44 am (UTC)There are reports, however, of MPA only causing splinter hemorrhages, or small areas of bleeding under the nails. As the Akatsuki always wear nail polish, this would be completely unobservable.
Hehehe, this fits well with my longstanding belief that the Akatsuki used the nailpolish to hide indicators of their health :D
no subject
Date: 2010-12-14 03:50 am (UTC)Well-presented, and it does fit with what we see in canon. I'm always a little leery of "And then he DIED HORRIBLY!" plots, so this is a nice little tidbit to slip into the background and make things sit a little better.
(I didn't much care about Itachi when he first appeared, but apparently
a degenerative diseasecoughing up blood and dying horribly will endear a character to me. Who knew.)no subject
Date: 2010-12-14 03:50 am (UTC)THIS IS AMAZING.
no subject
Date: 2010-12-14 04:19 am (UTC)no subject
Date: 2010-12-14 04:34 am (UTC)My original hypothesis centered around mycobacterial infections that acted like TB, and that the hemoptysis was the result of bronchiectasis, or recurring inflammation of the bronchial tubes from frequent TB-like infections. But it didn't add up. And the more I thought about it, the less likely an infectious origin was.
When I realized that diffuse alveolar hemorrhage was a far better explanation of the hemoptysis, things started falling more into place. It had to be due to some form of systemic vasculitis... The right one eluded me for around a month or so, but when I came across MPA in a journal I was reading, it was like a 'Dr. House moment!'
no subject
Date: 2010-12-14 04:34 am (UTC)no subject
Date: 2010-12-14 04:35 am (UTC)no subject
Date: 2010-12-14 05:15 am (UTC)no subject
Date: 2010-12-14 05:16 am (UTC)no subject
Date: 2010-12-14 06:12 am (UTC)no subject
Date: 2010-12-14 08:20 am (UTC)Can I be completely shameful and ask about the validity of the Kimimaro HIV theory?
*suddenly curious*
Date: 2010-12-14 09:25 am (UTC)no subject
Date: 2010-12-14 12:54 pm (UTC)Though if there are medical theories surrounding him, chances are when I do read those parts, I'll get intrigued... after all, Orochimaru's body transfer jutsu had me going for a while too! (And let me tell you, THAT jutsu is NOTHING to mess with. The medical implications are beyond intense and prove that as far as medics go, Kabuto might as well be Dr. House himself.)
no subject
Date: 2010-12-14 12:57 pm (UTC)Re: *suddenly curious*
Date: 2010-12-14 05:34 pm (UTC)no subject
Date: 2010-12-14 11:42 pm (UTC)no subject
Date: 2010-12-15 02:25 am (UTC)I wondered what sort of disease he had too and previously suspected it something like tuberculosis.
no subject
Date: 2010-12-15 06:13 am (UTC)even if it canon is probably the "mysterious vague manga disease", I totally prefer this over thatI'm mem'ing this, jsyk.no subject
Date: 2010-12-15 01:04 pm (UTC)no subject
Date: 2010-12-15 01:06 pm (UTC)no subject
Date: 2010-12-15 07:48 pm (UTC)no subject
Date: 2010-12-22 04:07 pm (UTC)Re: *suddenly curious*
Date: 2010-12-25 08:52 pm (UTC)re: itachi's mysterious sickness
Date: 2011-03-23 09:29 pm (UTC)re: itachi's mysterious sickness
Date: 2011-03-23 09:31 pm (UTC)no subject
Date: 2012-07-26 06:19 am (UTC)no subject
Date: 2012-07-26 06:22 am (UTC)no subject
Date: 2012-10-28 03:12 am (UTC)no subject
Date: 2013-02-01 02:38 am (UTC)Is there any actual treatment that might have cured Itachi? if it had been caught before the remission? Any and all information would be more than welcome!
no subject
Date: 2013-02-17 05:31 am (UTC)no subject
Date: 2013-05-03 02:50 am (UTC)no subject
Date: 2013-07-03 10:03 pm (UTC)no subject
Date: 2013-08-17 03:42 pm (UTC)Still well done this must have taken a lot of time and work and even though we can't be sure of exactly what desease itachi has this is an interesting possibility and fits well.
no subject
Date: 2013-10-01 06:41 am (UTC)no subject
Date: 2014-02-24 03:10 pm (UTC)no subject
Date: 2014-02-24 03:19 pm (UTC)no subject
Date: 2014-03-16 03:31 pm (UTC)Thank you so much for your research, I will probably site you and give you credit when the time comes :D
no subject
Date: 2014-04-16 05:14 am (UTC)"The average age of onset is usually in the fifth decade of life, but cases around Itachi's age have been reported in medical literature."
Regardless of how high the percentage is that it's not, there's still a chance. Otherwise it would be 100% instead of 90%. :/ Although I do feel the eyes bleeding thing isn't something that just happened to Itachi.
erm
Date: 2014-09-06 12:41 pm (UTC)the symptoms for Microscopic Polyangiitis infected in differnt parts is:
Lungs - breathlessness, wheeze, dry cough or coughing up blood
Skin - rashes, ulcers, and necrosis (death of tissue)
Eyes - red (blood shot) eyes, painful, dry or gritty eyes, visual loss or other changes in vision
Nerves - loss of sensation, weakness, unusual painful symptoms in the hands and feet (hotness, pins and needles or "electric shocks") and rarely paralysis or stroke
Bowels - Diarrhoea, bleeding and abdominal pain.
If it infecst the:
Lungs: itachi does not wheeze
Skin: he does not have rashes (especially at the leg)
Eyes: he have beautiful eyes <3
Nerves: he can still move properly i think
Bowels: he did not poop in the middle of the fight.
Also, if it affetcs the kidney, then it should be like this:
Kidney Inflammation
Inflammation in the kidneys, known as glomerulonephritis, causes blood and protein loss through the urine. This process can occur either slowly or very rapidly in the course of the disease. Patients with kidney inflammation may experience fatigue, shortness of breath, and swelling of the legs.
But itachi still has slim legs. :D
MPA usually affects the kidney... and kidney failure will cause swelling in a lot of body parts majorly at the legs. And it will lso cause one to be seeing hallucination (but itachi is still so well)
So, i dun really think MPA did really infected itachi. Althoguh alot of the symptoms match itachi's sickness. But there are also those which does not match and yea,..... it may not really be itachi's sickness i think.
A lot of diseases matches some of itachi's symptoms not all of the sumptoms course. but it is sure that itachi suffers from haemoptysis which normally includes chest pan. (And , one more thing.... i think itachi is having angina pectoris (since he only pulls his shirt at the position of his sternum .... not myocardial infarction i think. )
And actually there is TONS of diseases related to Hemoptysis, so yeah... there is just too much to explain until masashi revealed it. haha
Itachi's Eyes
Date: 2016-09-21 10:50 pm (UTC)no subject
Date: 2017-08-14 05:45 pm (UTC)Update please
Date: 2018-09-14 10:00 pm (UTC)no subject
Date: 2018-10-27 02:02 pm (UTC)Hope this works.
Date: 2018-12-27 02:39 am (UTC)for fanfic!
Date: 2024-07-08 08:37 am (UTC)That said, if you don't mind, I'll be going with this theory to write on my Itachi fanfic, in terms of the symptoms and decease and how it progresses! I hope it is fine! I believe by grounding his illness progression with this it can create a realistic, gradual sense of how the illness develop and his fight against it (even tho maybe the medical in shinobi world is not as advanced about medicine so he'll have a harder time to suppress it)!