Patients and methods A cross-sectional study included 100 SLE patients fulfilling the American college of Rheumatology (ACR) revised classification criteria for SLE(Hochberg, 1997). All patients were recruited randomly from the Rheumatology outpatient clinic and the inpatient ward of Internal Medicine and Rheumatology department, Ain Shams University hospital. Exclusion Criteria: - SLE patients age < 18 years. - SLE patients with diabetes mellitus (DM) Ethical considerations: The nature of the present study was explained to all participants. The laboratory and radiological procedures represent standard care and pose no ethical conflicts. Informed consent was obtained from all participants All patients were subjected to the following: …show more content…
Twelve systems are assessed by 41 items for damage, which is defined as non-reversible change that is not related to active inflammation and that has occurred since the onset of lupus, ascertained by clinical assessment and present for at least 6 months. If evidence of damage is noted for a particular item, it is given a score of 1. Some items may score 2 points if they occur more than once, so that the maximum possible score is 47. Scores can only increase with time, but scores rarely reach over 12 (see details in the appendix, page…). V- Laboratory investigations: 1- Complete Blood Picture (CBC).by coulter (Britten et al., 1969). 2- Erythrocyte Sedimentation Rate (ESR).in first hour by Westergren method (Hoffmin et al., 2004). 3- Serum creatinine and blood urea nitrogen (BUN) by calorimetric method (Thomas, 1998). 4- Urine analysis. (Ruggenenti et al., 1998). 5- Protein/creatinine ratio(Ruggenenti et al., 1998). VI- Tuberculin skin test (TST) The TST was performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The injection was made with a tuberculin syringe, with the needle bevel facing upward injecting intradermally to produce a pale elevation of the skin (a wheal) 6 to 10 mm in diameter. The skin test reaction was read between 48 and 72 hours after administration. The reaction was measured in millimeters of the
The awareness of SLE has spread exponentially during the last decade, this is observed especially for women who are getting diagnosed earlier and then move on to treatment. However,
Lupus is a chronic inflammatory disease of unknown cause that can affect virtually any part of the body. The medical term for Lupus is Systemic Lupus Erythematosus or better known as SLE. With Lupus there is a malfunction in some of the cells of the immune system. "In Lupus, the body overreacts to an unknown stimulus and makes to many antibodies, or proteins directed against body tissue. Thus, Lupus is called an autoimmune disease. ”#
ANA: test for these autoantibodies (very general); DsDNA (+): Making antibodies to and attacking own DNA; Anti-Sm (+): these antibodies generally interfere with the cells metabolism and are responsible for the symptoms specifically seen with SLE. Here, they are specifically targeted at smooth muscle. CRP elevated: also indicates presence of inflammation, but is more specific towards disease activity; ESR elevated: indirectly indicates the activity of the disease and presence of inflammation; C3 and C4 (decreased): C3 and C4 usually attack the membranes of viruses and bacteria, but in the case of lupus, they attack the own body’s cells. When C3 and C4 suggest the disease is active
Cynthia is a 65 year old African American female diagnosed with type 2 diabetes mellitus, diabetic peripheral neuropathy, hypertension, kidney disease, hyperlipidemia and hypothyroidism. She is on glipizide 5 mg po daily to treat her type 2 diabetes. Cynthia revisited the clinic soon after the initiation of the treatment with symptoms of shakiness, sweating, chills, clamminess, lightheadedness and moderately severe headache. In this case study, Cynthia is exhibiting the symptoms of hypoglycemia as she is on sulfonylurea therapy. Sulfonylureas, such as glipizide commonly used as a second-line of therapy in patients with Type 2 Diabetes Mellitus (T2DM), promote insulin release independent of prevailing glucose value and as a result,
Let alone the cause of this horrible disease. One of the most commonly suspected reasons for systemic lupus erythemotosus (SLE) is a very low iron count. Low iron has a veriaty of effects on the body including the feeling of being cold, low blood count (anemia), and impaired immune defiecency, ect.. Thus the low iron syptom seems to add up with lupus making doctor think that low iron can have a leading from in the disease.
Systemic lupus erythematosus (SLE) also referred to lupus dates back to the middle ages and has made an explosion in the past 60 years. Even though more than 1.5 million Americans have lupus and 90% of lupus sufferers are women, between the ages of 15 to 44 (Lupus Research Institute), there is little awareness about the disease. 72% of Americans aged 18-34 have either not heard of the disease or know nothing about it (Medical News Today). However, researchers continue on working to have a better understanding of SLE factors, pathophysiology, current treatment and new prospects for treatment.
It is not rare for individuals with lupus to undergo muscle throbs and discomfort or have inflammation of certain muscle groups, which causes faintness and loss of intensity. More than 90 percent of people with lupus will encounter joint and/or muscle pain at some time during the path of their illness. In lupus, the immune system of the body raids its own cells and tissues. Precisely, the joints, skin, kidneys, lungs, heart, nervous system, and other organs of the body are affected. Lupus affects generally 10 times as many women as men. Most often, lupus develops in people 18 to 45 years old. (Lahita) Though lupus is most dominant among women, it also may affect men and children, as well as individuals of all ages. Lupus effects each person
Diabetes Mellitus (DM) or Type 2 Diabetes is seen as a metabolic disease that is categorized by abnormally high blood glucose or hyperglycemia. Diabetes Mellitus is also formerly known as noninsulin-dependent diabetes mellitus and is the most common form of diabetes that is seen. Insulin is a hormone that is supplied to the body that allows us to efficiently use glucose as fuel. When carbohydrates are broken down into sugars in the stomach glucose enters the blood circulation simulating the pancreas to release insulin in an appropriate amount to become used for energy. With diabetes mellitus the body does not properly make use of the insulin supplied for the body. This causes the pancreas to produced an extra amount if insulin which the body cannot keep up with, causing an imbalance to the blood glucose levels (American Diabetes Association, 2015). In the united states diabetes affects almost 29.1 million people, while the another 86 million people have pre-diabetes but do not know. It is also known as the 7th leading cause of death in the country in the recent years (MedicineNet.com, 2016). For a patient suffering from a chronic form of diabetes mellitus understanding how these mechanisms lead to the condition can be used as preventative measures. Potential consequences as well as the causes and clinical manifestations will ensure a better knowledge on the issue to monitor the condition.
Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African Americans experience the disease more severely than other racial-ethnic groups. We performed a systematic review in the PubMed and Medline Databases of articles published between January(?) 2000 – December 2014 to evaluate research focused on SLE in African Americans. Articles were classified according to their level of evidence. Our literature review reported a wide range of adverse outcomes in
Systemic lupus erythematosus (SLE) is a disease in which a person’s own immune system begins to recognize its own tissues and organs as foreign antigens which causes it to attack and injure those targeted structures (Perspectives 14). Discoid lupus erythematosus (DLE) causes coin-shaped lesions to appear on the skin and does not affect any other system other than the integumentary (Perspectives 23). As stated on the Mayo Clinic website the etiology of the disease is idiopathic, but it is believed that environmental factors and inherited genetic code may contribute to the formation of lupus. Lupus can also be triggered by sunlight, infections, and medications such as anti-seizure and hypertension prescriptions (Mayo Clinic). Iatrogenic cases of the disease often have their symptoms reduced or eradicated after stopping those medications (Mayo Clinic). Diagnosis of the disease is based upon criteria set in place by the American College of Rheumatology as lupus often affects the muscle and joints (Lupus.org). The list is comprised of eleven common signs and symptoms that have been observed by rheumatologists. They are: Malar or
Systematic lupus erythematosus (SLE) is a chronic, systemic, autoimmune disease. This condition causes the body to mistaken its own tissues and organs as foreign bodies and begins attacking them causing continuing inflammation and pain. (Huether & McCance, 2012) The cause of SLE still remains unknown, but it is possible that is inherited as a complex trait or caused by environmental stimuli. (S) Anyone is at risk for Lupus, but is more common among women than men and is more prevalent of African Americans and Asians. (National Library of Medicine 2010, para 2) This condition can be difficult to diagnose, as a patient must present a number of the recognizable symptoms. Depending on the location that Lupus presents itself in the body, the symptoms
The American College of Rheumatology (ACR) and the Georgia Council on Lupus Education and Awareness (GCLEA) partnered to increase community awareness on Systemic Lupus Erythematosus (SLE) and to further educate lupus patients throughout the underserved region of southwest Georgia. Systemic Lupus Erythematosus, the most common form of lupus, is an autoimmune disease that causes the immune system to attack needed body tissues (“Lupus,” 2018). This specific type of lupus affects major functions of the body including the brain, lungs, skin, and kidneys. Lupus is commonly difficult to diagnose in humans due to its vague symptoms that mimic the symptoms of other major conditions (‘Lupus,” 2017). Presently, researchers are unaware of the origins
Autoimmune diseases materializes when the immune system becomes perplexed and vicious assault the human body, devastating tissue. Thus, both Lupus and RA (Rheumatoid arthritis) are destructive autoimmune diseases. Nevertheless, it is currently undetermined what activates these diseases, but they are regrettably genetic in nature. Both diseases coalesced affect approximately 24.2 million Americans. Though they share similar symptoms, each has its unique way of inflicting excruciating and debilitating discomfort to the human body. This essay will explore the similarities and variances between the two.
Assessment (an estimate of activity rated on a 0 to 3 visual analog scale), the most common
Systemic Lupus Erythematosus is a chronic autoimmune disease which causes inflammation of your joints, tissues, and organs. The inflammation presents itself as heat, pain, swelling and redness. SLE is a variable disease that doesn’t take any one particular course; therefore its unpredictability makes it even more devastating. No two people will experience the same disease symptoms or severity level. As S.L.E progresses there will be periods of very subtle to no symptoms at all called remission or an exacerbation of symptoms called flares.