DEAR DR. DONOHUE: We have four children, three boys and one girl. In 1981, our youngest son lost his kidneys to glomerulonephritis and was on dialysis for two years. Finally, he had to have a kidney transplant, and his oldest brother was the best candidate for donating a kidney. Four years ago, this oldest son was diagnosed with an autoimmune disease of the blood called antiphospholipid antibody syndrome. It makes his blood thick and forms clots. He is on a high dose of blood thinner. He has lost part of his right foot because of a clot.

Our second-oldest son has autoimmune liver disease, and his daughter has lupus. Our biggest concern is for the oldest son. His blood is so thin now that he doesn’t heal well. His immune system has to be fixed. As parents, we wonder if we gave our children all this autoimmune illness. Any information you give would be appreciated. — M.D.

ANSWER: Your family has suffered from a complicated assortment of serious illnesses. You wonder if genes are involved. A genetic influence can be found in all the illnesses you mention, but that’s not saying you and your husband are responsible for these illnesses. Genetic influence is only part of your children’s story. How much it contributes to their illnesses can’t be determined at present. You are no more responsible than your parents, their parents and their parents’ parents.

Antiphospholipid antibody syndrome comes from proteins (antibodies) made by the immune system. These antibodies prevent phospholipids from carrying out their function in preventing the formation of unwanted blood clots. Treatment consists in putting an affected individual on Coumadin. This medicine is called a blood thinner. It doesn’t “thin” the blood; it keeps it from clotting. It doesn’t interfere with the blood’s healing properties. If Coumadin doesn’t stop clots from appearing, aspirin can be added to the program. And, if necessary, other medicines can be put into play. What causes the syndrome is still a guess.

Autoimmune liver disease and lupus also are due to an immune system that is misfiring. I can’t tell you if all of these illnesses are interrelated. I can tell you that you and your husband are not to blame for them.

DEAR DR. DONOHUE: I have an ear problem. When I get up every morning, both ears are red and swollen and they hurt terribly. Sometimes they get that way during the day. My pharmacist told me that his son has the same problem. He said the doctor didn’t have an answer for it. Neither does my doctor. I hope you can help. — F.W.

ANSWER: It could be relapsing polychondritis (POL-ee-con-DRITE-iss), recurrent inflammation of the ear cartilage. The ear is mostly cartilage, except for the earlobe. If your earlobe doesn’t turn red during an attack, that’s evidence in favor of this diagnosis. You need a second opinion. Other cartilage can become involved — the nose, eyes, joints and breathing tubes. Prednisone, one of the cortisone drugs, usually controls the illness. Aspirin, indomethacin, dapsone and methotrexate also are used.

DEAR DR. DONOHUE: This winter I slipped on the ice and fell. Will you explain my X-ray report? I am 77. — M.G.

ANSWER: The report says you have no broken bones. It also says you have some arthritis changes in your wrist. That’s the meaning of “degenerative changes.” Degenerative changes equate to osteoarthritis. Almost every person over 60 has similar changes in one or more of their joints.

So long as your wrist doesn’t hurt and isn’t stiff, you can dismiss this as something that happens with age. You don’t have to do anything about it.

DEAR DR. DONOHUE: Will you please tell me what a legume is? I see it in many articles on nutrition. Legumes are always promoted as healthy foods. I must be missing out on something. — R.S.

ANSWER: I’m sure you have eaten many legumes. Legumes are vegetables and other plants whose seeds are contained in pods, like peas and beans. Peanuts are also legumes.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.