Your patient is a married 47 year old white female homemaker with 2 children and
ID: 89264 • Letter: Y
Question
Your patient is a married 47 year old white female homemaker with 2 children and an 18 year history of systemic lupus erythematosus (SLE). She has no known allergies. The pt takes an occasional naproxen for joint pain and antacid for heartburn but no other prescription or OTC (over the counter) medication. She neither smokes nor drinks alcohol (ETOH). Except for lupus, the patient's medical history is unremarkable. She is 5 feet 5 inches in height and weighs 102 pounds which is a decrease in weight of 23 pounds since her last physical examination nearly a year ago. She has had several small patches of hair loss on her head and her joints often hurt. Her ESR (erythrocyte sedimentation rate) is elevated at 70. She has a red rash on the sun exposed parts of her skin that looks like a vasculitis. She has 4 brothers and 3 sisters. An older sister has rheumatoid arthritis (RA) and an aunt with pernicious anemia and her deceased mother had Graves disease. What is the significance of the patient's family history? What is the pathophysiology that underlies her hair loss and the abnormal ESR? What causes vasculitis in SLE? Why might prednisone improve the rash?Explanation / Answer
1. Families have many factors in common, including their genes, environment, and lifestyle. Together, these factors can give information that can be used in the to medical conditions that may run in a family. By noticing patterns of disorders among relatives, healthcare professionals can determine whether an individual, other family members, or future generations may be at an increased risk of developing a particular condition.
2. Lupus is an autoimmune disease. Systemic lupus erythematosus (SLE) is the most common type and affects multiple organs in the body. There are a number of ways in which lupus can have an effect on the hair with systemic lupus (SLE) the immune system can actually destroy hair follicles. or even the hair might become thinner all over, or fall out in clumps. ESR was conducted to detect inflammation in the body. This can be useful in diagnosing conditions that cause inflammation, such as autoimmune diseases, cancers, and infections. since paitent is suffering from Systemic lupus erythematosus which is an autoimmune disorder. Thus, resulting in hairloss and abnormal erythrocyte sedimentation rate.
3.Vasculitis is one of the potential complications of lupus as the body’s immune system attacks the blood vessels. Blood vessels include arteries, veins and capillaries which carry blood through the body and back to your heart.One of the consequences related to systematic lupus is rash formation on a skin due to the progression of inflamation because of autoimmune disorder. Prednisone is a corticosteroid. It works by decreasing or preventing tissues from responding to inflammation. It is prescribed as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some autoimmune diseases. Thus prednisone might improve the rash.
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