As one of the most successful and critically acclaimed medical drama series of all time, House accomplished many things in its eight-season run and also brought awareness to many medical conditions that viewers had likely never heard of before. However, as serious as the series might have been, there was also an ongoing gag within the series pertaining to one diagnosis that never seemed to quite fit. Until it did.

Dozens of times throughout the show, the differential diagnosis of the autoimmune disease lupus was offered by Dr. Gregory House (Hugh Laurie) and his team, most notably immunologist Dr. Allison Cameron (Jennifer Morrison). Here, we’ve recapped some of the most memorable lupus theory episodes, including the one time it finally was the elusive condition in question.

10 Not Lupus: Dr. Ezra Powell

In the third season episode ‘Informed Consent,’ famed doctor Dr. Ezra Powell (Joel Grey) becomes a patient of House and his team of medical ducklings. After suffering difficulty breathing and occasional fainting episodes, Dr. Powell has come to Dr. House for his expert opinion.

Over the course of the lengthy diagnostic period, House briefly wonders if Powell might have lupus. However, since this is House, it winds up not being lupus, but rather a terminal diagnosis of amyloidosis. Cameron euthanizes him at his request with a lethal dose of morphine.

9 Not Lupus: Jeff Forrester

The second season episode ‘Spin’ is one of many episodes in the series that offers its own version of topical news stories. In this case, the episode focuses on the patient Jeff Forrester (Kristoffer Polaha), a clear analog to legendary cyclist Lance Armstrong, who has admitted to doping in order to improve performance.

During a race, Jeff enters an episode of respiratory distress, which is what leads him to wind up under Dr. House’s care. Dr. Chase and House each initially believe Jeff could be suffering from lupus, but the culprit turns out to be a tumor on his thymus gland, which caused complications including myasthenia gravis.

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8 Not Lupus: Anica Jovanovich

The second season episode ‘Deception’ represents one of the rare occasions during which House actually forms a somewhat meaningful connection with a patient. Anica Jovanovich (Cynthia Nixon) is a woman House meets during a visit to an off-track betting location before she suffers a seizure.

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During the early diagnostic brainstorming session, Cameron offers a lupus theory – as she so often does – even though the symptoms don’t wind up making sense. In the end, Anica is diagnosed with both Munchausen syndrome and a bacterial infection.

7 Not Lupus: Fletcher Stone

The second season episode ‘Failure to Communicate’ is memorable for one particular reason: it’s an episode that finds House trying to diagnose a patient despite being hundreds of miles away. Journalist Fletcher Stone (Michael O’Keefe) was the patient of the week in this episode, after he suffered a fall, banged his head, and began speaking indecipherably.

Throughout the diagnostic process, Fletcher continues to speak in a manner that the doctors are forced to try and translate. Cameron once again offers the suggestion of a lupus diagnosis, but once again, she’s incorrect. In the end, in addition to his secret diagnosis of bipolar disorder, Fletcher is discovered to have contracted cerebral malaria.

6 Not Lupus: Keith Foster

The first season episode ‘Detox’ focuses on the case of teenaged patient Keith Foster (Nicholas D’Agosto), who is admitted to Princeton Plainsboro after being in an accident. He had been coughing up blood prior to the accident, however, which made it clear that not all of his symptoms were due to it.

After running blood tests, Cameron believed (once again) that Keith could be displaying signs of lupus, despite having no other visible common symptoms. His diagnosis winds up being one of the rarest in the entire series: naphthalene poisoning, as a result of termite infestation.

5 Not Lupus: Abigail Ralphean

In the third season Christmas episode ‘Merry Little Christmas,’ the central patient is a young girl believed to be medically classified as a dwarf, Abigail Ralphean (Kacie Borrowman). Having previously suffered from a collapsed lung seemingly without cause, Abigail soon piqued House’s curiosity.

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As the team tried to make sense of what could have caused Abigail’s lung to collapse, Cameron once again offered the autoimmune theory, leading to lupus. In the end, it was, in fact, an autoimmune disease, but rather the rare condition known as Langerhans cell histiocytosis.

4 Not Lupus: Lucy

Lucy (Bailee Madison) is one of the youngest patients on the series to be suspected of having lupus. At only six years old, she is the main patient in the third season episode ‘Act Your Age,’ when she is admitted into Dr. House’s care after collapsing with severe symptoms in school.

During the diagnosis, it was discovered that Lucy was displaying signs of conditions never seen in children, but rather older adults. As an attempt to explain it from the immunology perspective, Cameron once again offered lupus. But the surprise diagnosis came as a result of Lucy coming into contact with her father’s testosterone enhancing cream, which led her to develop rapid puberty.

3 Not Lupus: Dr. Cate Milton

House didn’t just manage to diagnose a patient on a remote basis once. In fact, he once did something far more impressive than the Fletcher Stone case, when he took on the case of Dr. Cate Milton (Mira Sorvino), a researcher stationed in the South Pole, in the fourth season episode ‘Frozen.’

Dr. Milton reported symptoms including severe abdominal pain, vomiting, dehydration, and respiratory issues. House eventually suggested that Dr. Milton could have an autoimmune disease, including lupus as one of the options. In the end, it was revealed that Dr. Milton had suffered from an embolism as a result of breaking one of her toes.

2 Not Lupus: Will Westwood

 

House and his team were still trying to diagnose patients with lupus as late as the series’ final few episodes. In the eighth season episode ‘Love Is Blind,’ Will Westwood (Michael B. Jordan) is the patient of the week, a blind young man who suddenly suffers total sensory stimulation and is rendered virtually helpless while attempting to cross the street.

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House and his team eventually noticed a clot in his brain, which Dr. Adams believed could have been caused by a condition such as lupus. In the end, the cause of his symptoms is revealed as the infection mucormycosis, which causes him to suffer from hearing loss as well after treatment.

1 Lupus: Flynn

It took all the way until the series’ fourth season, but in the memorable episode, ‘You Don’t Want To Know,’ the patient’s final diagnosis did indeed turn out to be lupus for once. It’s the only episode in the entire series to boast such a diagnosis, despite the many, many, many times House and his team try to suggest it.

In the episode, magician Flynn (Steve Valentine) becomes severely ill while attempting to escape from a tank filled with water during a performance. His symptoms include episodes of bleeding, both internally and from the mouth, numbness, and seizures. And in the end, House finally realized that, for once, it was in fact lupus.

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