Lives of the fellows

Ronald Andrew Asherson

b.19 December 1934 d.7 May 2008
MB ChB Cape Town(1957) FCP SA(1964) FACP(1987) FACR(1987) FRCP(1994)

Ronald A Asherson was an internationally renowned authority on autoimmune diseases, especially antiphospholipid syndrome (APS). He made numerous contributions to the recognition and characterisation of the many clinical manifestations associated with the antiphospholipid antibodies, including the original description of the most severe variant of the syndrome.

He was born in Cape Town, South Africa, and qualified in medicine at Cape Town University in 1957. He moved to England and became house officer to Sir Christopher Booth at Hammersmith Hospital, London. In 1961 he accepted a fellowship at the Columbia Presbyterian and Francis Delafield hospitals in New York, returning to South Africa to become a senior registrar at the Groote Schuur Hospital in Cape Town. After ten years as a clinical tutor in its department of medicine, he went back to the United States and was appointed as assistant clinical professor of medicine at the New York Hospital-Cornell Medical Center under Henry O Heineman. From 1981 to 1986 he was associated with the rheumatology department at the Royal Postgraduate Medical School of London (Hammersmith Hospital), working under Graham R V Hughes. It was at that time that he developed his interest in systemic autoimmune diseases and antiphospholipid antibodies. In 1985 he moved with Hughes to the Rayne Institute at St Thomas’ Hospital to create the world-renowned lupus unit. In 1991 he took a sabbatical at St Luke’s Roosevelt Hospital Center in New York, working with Robert Lahita. In 1992, he returned to South Africa to become principal scientific officer at the rheumatic disease unit, Groote Schuur Hospital in Cape Town, and later associate professor at the division of immunology, school of pathology, University of the Witwatersrand, Johannesburg. He was also visiting professor at the department of autoimmune diseases, Hospital Clinic, Barcelona, Catalonia, Spain.

His research output included over 500 scientific articles and more than 100 chapters in leading textbooks on rheumatology and internal medicine. He also edited several books, including Phospholipid-binding antibodies (Boca Raton, Florida, CRC Press, 1991), Vascular manifestations of systemic autoimmune disease (Boca Raton, Florida, CRC Press, 2000), and two editions of The antiphospholipid syndrome (Boca Raton, Florida/London, CRC Press, c1996, second edition: Amsterdam/Oxford, Elsvier Science, 2002), and was series editor of ten volumes of Handbooks of systemic autoimmune diseases.

His main contributions to medicine included the recognition, together with Graham Hughes and other members of his team, of the primary APS and of several clinical manifestations of the syndrome (i.e. the adrenal involvement), but mainly the original description of the catastrophic APS. In collaboration with several investigators from all over the world, he created an international registry of this condition, as well as classification criteria and guidelines for management that have reduced its mortality from more than 50 per cent in the early series to less than 30 per cent in the more recent reports. In 2003, after the 10th International Congress on Antiphospholipid Antibodies held in Taormina, Italy, several colleagues proposed the eponym ‘Asherson’s syndrome’ to name this variant of APS.

In 1987 he was elected a fellow of the American College of Physicians, as well as a founding fellow of the American College of Rheumatology. From 1988 to 1991 he was on the council of the Royal Society of Medicine in London. Among other awards, in 1992, he was the co-winner of the European League Against Rheumatism prize and in 1993 was part of Graham Hughes’ team awarded the International League Against Rheumatism prize, both for research on antiphospholipid antibodies.

He was a wonderful speaker, who influenced many scientists and physicians, and a great traveller, collecting not only intellectual and cultural experiences and interesting cases from all over the world for medical journal reports, but, more importantly, good and respectful friends. He died in Johannesburg, South Africa, and leaves an immense human and professional legacy.

Ricard Cervera

(Volume XII, page web)

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