1.What is the significance of each of D.W.'s laboratory findings?
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
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SLE diagnosis is made on 4 findings present at the same time or in a series. 11 common findings include: malar rash, disc shaped rash, photosensitivity, oral ulcerations, nonerosive arthritis, serositits, presence of ANA, and renal, neurologic, hematologic, and immunologic disorders. The X-ray finding is also significant, because the inflammation without erosion of the joints is a key finding in SLE. Other labs (like those listed above) are used in combination to also aid in diagnosis of SLE.
Retrieved from pathophysiology immunity PowerPoint (by Dr. Pyrus)
4. Which laboratory findings concern you, and why?
Urinalysis/BUN/Creatinine: RBCs and protein in the urine plus the elevated renal labs indicates that the disorder has now also affected the kidneys, which is considered one of the worse complications in lupus.
These electrolyte imbalances (Sodium low, Chloride elevated) also correspond with dysfunction of the kidneys. http://www.lupus.org/answers/entry/lupus-and-kidneys 7. What other findings indicative of central nervous system (CNS) involvement from SLE should D.W. be assessed
Some may include: Achy joints, Fever of over 100 degrees, arthritis, extreme fatigue, skin rashes, anxiety, kidney involvement, pain in the chest area or trouble breathing, rash, light sensitivity, hair loss, blood clotting problems, seizures, and mouth and nose ulcers. This is a giant list of symptoms, but many people who have Lupus do not experience more then one or two of these symptoms. (The Lupus Foundation of America, The Lupus Page)
Lupus may also affect the blood. Anemia is common in individuals with Lupus, with this condition there is a low read blood cell count, the red blood cells are coated with antibodies that cause them to break down and break apart. Leupkopenia is also common, with this condition there is a low white blood cell count. This can lead to an increased susceptibility to infections. Thrombocytopenia is also common; with this condition people have trouble
The most common symptoms are fatigue, rashes, or joint pain. Other symptoms that might develop are skin problems, sensitivity to light, neuropsychiatric problems, fever, changes in weight, hair loss, and/or swollen glands. Some specific skin problems are skin rashes, i.e., the facial butterfly rash. Raynaud’s phenomenon is often common, affecting the fingers, toes, ears, or tip of the nose. About 90% of lupus patients have fatigue in various degrees. Symptoms depend on what body organs are affected and how seriously they are affected. This disease can cause problems in nearly any system of the body, including the:
Szuda, Stephanie “Health: Life with Lupus.” The Times. 11 Jan 2008. 19 Nov 2010. <Mywebtimes.com>
Lucci the patient had systemic lupus erythematosis, his silver eyebrows pointed to heaven, and he broke out into a big smile. When he asked me to explain why the patient had lupus, I named the fourteen manifestations of lupus and told Dr. Lucci the diagnosis of lupus was contingent on a patient's having at least four of the fourteen manifestations. His patient did indeed have five of the fourteen manifestations: non-deforming arthritis, Raynaud's phenomenon, in which the hands exhibit a two-phase color change when placed in cold water, alopecia or hair loss, oral ulcerations, and what appeared on the chest X-ray to be a pericardial effusion which suggested pericarditis.
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
Systemic Lupus Erythematous will affect people in different ways. The joints, lungs, kidneys, blood, the heart affected are the worst affect Systemic, .Lupus Erythematous can damage a person that have it. The type of lupus is also often categorized by periods of flare when the disease is living and periods of decrease when the disease is hidden. The signs and symptoms range from rashes on the cheeks, Ulcers in your mouth, red palms and hands, joint pain, joint redness, swelling of the joints, their face and legs become very swollen, the shortness of breath, rapid or irregular heartbeat, chest pain, hair loss, swelling of lymph glands, protein in the urine, increase sensitivity to the sun and last but not least mental changes. The people that have lupus in the blood will be affect because they may start developing anemia, leukopenia which is a decreasing number of white blood cells, or thrombocytopenia which is a decreasing in the number of platelets in the blood, which assist in clotting. A lot of people with the disease lupus that on autoantibody called antiphospholipid antibodies have an increased risk of blood clots. The people that have lupus in the heart are at risk because of the inflammation can occur in the heart itself or the membrane that surrounds itself (pericarditis), causing chest pain or other symptoms. The disease lupus have endocarditis which can damage the heart
Lupus is a chronic, autoimmune disease that causes swelling, pain, and inflammation throughout the body. An autoimmune disease is when the white blood cells inside a person’s body cannot tell the difference between healthy tissue and foreign invaders. That cause the white blood cells to attack and kill the tissue in body systems, including organs like the heart, brain, lungs, and kidneys. When diagnosing for lupus it is extremely difficult. This is because the signs and symptoms of Lupus often imitate those of other diseases. The sign that differentiates Lupus from other diseases, is a facial rash that resembles a butterfly across the cheeks and nose. This is an often seen sign but it doesn’t always occur. There are several types of Lupus including
Makover, M. & Zieve, D. (2011, February 14). Systemic Lupus Erythematosus. National Center for Biotechnology Information. Retrieved July
Systemic Lupus Erythematosus, or Erythematous, also known as SLE, is a chronic inflammatory, autoimmune disease that transpires when the body’s own immune system assaults, with “variable manifestations”, it’s own tissues and organ systems throughout the itself1,2,3. This can also include joints, heart, lungs, skin, brain, blood cells, etc1. Systemic Lupus Erythematosus is known to have an impact on the organ network involved with immune complexes and multiple antibodies, especially antinuclear antibodies, or ANAs, an abnormal antibody that is targeted to cause certain edemas throughout the body and different tissues4.
There are five main symptoms that most patients with lupus nephritis present (The Nat’l Kidney Foundation). Hematuria and proteinuria are usually the initial symptoms and involves the glomeruli leaking protein and/or blood into the urine. As the kidney disease progresses, edema can develop due to extra fluid that the kidneys cannot remove. This in turn, causes weight gain although you’re more likely losing weight with this disease – that is, fat. High blood pressure is also developed due to heart and blood vessel problems. Kidney symptoms usually develop during or shortly after lupus symptoms. The lupus symptoms include joint pain, swelling, muscle aches, fevers with no known cause, and red rashes on the face. The initial diagnosis of lupus is usually simple, but in most cases other diseases are suspected first. The full diagnosis can be postponed due to its ability to mimic other diseases and conditions. Series of tests are completed in order to determine how far the disease has progressed. Urine and blood tests are performed to find out if there are abnormal levels in the blood and if anything abnormal is present in the urine. Blood tests for lupus nephritis generally check for protein and cholesterol levels; the glomerular filtration rate (GFR); and antiphospholipid antibodies and anti-nuclear antibodies (ANA). Presence of ANAs, along with most
Lupus is a chronic inflammatory disease marked by its effect on various parts of the body, including the joints, skin, blood, and kidneys. It is a condition in which the body's immune system attacks its own cells and tissues, resulting in pain, inflammation, and often damage to organs. Lupus involves the immune system. The immune system makes antibodies that work to protect the body against foreign substances like viruses and bacteria. Such foreign bodies are called antigens. When a person has lupus, his or her body is unable to determine the difference between antigens and the individual's cells and body tissues. As such, the immune system creates antibodies against the individual's own tissues. These antibodies are called autoantibodies. Depending on the type of lupus, a wide range of symptoms may be experienced, from rashes, hair loss, and achy, swollen joints to fever, anemia, and abnormal blood clotting. Though the disease can affect many parts of the body, individuals usually experience symptoms in only a few organs. There is no known cure for lupus. However,
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.
Thus, testing for ANA or ANA-specific autoantibodies have been incorporated in a number diagnostic criteria. For example, a positive ANA finding was incorporated as a diagnostic criterion for SLE [18, 19]. In 2013, a joint committee of the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) formulated a new set of SSc classification criteria which included the ANA-specific autoantibodies, namely; anti-topoisomerase I (anti-topo I or anti-Scl-70), anti-centromere (ACA), and anti-RNA polymerase III (anti-RNAP III [20].
When it comes to alcohol, it is advised to have it responsibly. However, when it comes to a Lupus sufferer things are bit more critical. Undoubtedly, they are vigilant, but in certain situation that is not enough. If you are on Methotrexate or on NSAID drugs like naproxen or ibuprofen, alcohol can interfere with the drugs. As a result either the drugs could work as they were supposed to or in severe cases you end up with an internal bleeding or an upset stomach.