CasePresentation- Lupus Erythematosus
CasePresentation- Lupus Erythematous
The case presented is that of a female patient diagnosed withsystemic lupus erythematosus. The focus of the case is an explanationof clinical presentation of the condition among the affected patientsand a discussion of the corresponding pathophysiology of the clinicalproblem. The pathophysiology will be illustrated based on how itrelates to the symptoms, treatment, and prognosis.
Jane is a 24-year-old female who came for an obstetrics check-up fourweeks post miscarriage. Jane was eight weeks pregnant when shesuffered the miscarriage. The patient has not been working since shehad the miscarriage and complained of fatigue and arthralgia. She isnot taking any medication. She complains of a decrease in appetite,difficulty sleeping, joint swelling and stiffness.
The onset of systemic lupus erythematosus is acute. The condition cango undiagnosed for decades. Various features are linked to thedevelopment of the condition. Patients suffer from nephritis,cardiopulmonary infections, skin rashes, and inflammations (Choi,Kim, & Craft, 2012). Patients affected by the condition may atfirst appear as if they are extremely fatigued, experience a feelingof discomfort, weight loss, and fever. However, there could bevariations in the body systems affected. The musculoskeletal systemcould be characterized by features such as joint swelling, pain whilein motion, morning stiffness, and arthralgia (Lisnevskaia, Murphy, &Isenberg, 2014). Patients are suffering from an affectedintegumentary system present with rashes on the skin, sores, andlesions all of which are provoked by exposure to sunlight. Patientscan sometimes suffer from heartburn, poor blood circulation to thefingers and stomach pain. Pregnant women can have miscarriages(Bramham et al., 2011). The renal malfunction can occur because ofsystemic complications.
Pathophysiologyof the Condition
Various factors are associated with the clinical manifestations oflupus erythematosus. A combination of genetic, hormonal andenvironmental factors are linked to the condition. Jane is evidentlyin her childbearing years meaning there are changes in her hormonalsystem. It could explain the rationale behind her presentation withthe symptoms. Environmental factors such as medications the patienthas been using can as well be linked with the condition. Notabledrugs that have such an effect include hydralazine, isoniazid andanticonvulsants are associated with lupus erythematosus.Polymorphisms in the individual’s DNA sequence can as well increasethe chances of one developing the condition. However, multiplegenetic factors are thought to contribute to the onset of thecondition. It is essential to understand that the genes affected havea crucial role to play in the immune system function. If the genesaffected fail to function normally, the chances are that it would bedifficult to control normal immune responses. The effect of suchchanges are the autoimmune antibody attacks on the body systems.Lupus erythematosus is an autoimmune disorder that affects variousbody systems (Ahmadpoor, Dalili, & Rostami, 2014). Theidentified three factors can be attributed to the development of thecondition. Jane’s history indicates that her mother had beendiagnosed with lupus, but she died in a road accident. The diagnosisof the mother with the condition could suggest that she could haveinherited the condition from her. Jane has not been exposed to anymedications likely to predispose one to the condition.
Pain, swellingand stiffness of her joints
Skin rash onexposure to sunlight
Treatment of lupus erythematosus can be a challenge because of lackof a cure. The treatment discharged for the patient depends on thesymptoms they present with. Jane had previously had a miscarriage andexhibited signs of fatigue, restlessness and difficulties sleeping.Further, she experienced pain, swelling, and stiffness in the joints.Because of her condition, she could get conservative treatment.Anti-inflammatory drugs could help her in managing the condition. Theskin rash on her skin especially on exposure to sunlight could belinked to inflammation (Choi et al., 2012). The use ofnon-inflammatory drugs helps reduce the symptoms of the patient.Further, the patient can be treated with drugs that aim at blockingher body’s hyperactive immune system. Notable medications that areeffective in dealing with the condition are azathioprine andcyclosporine (Lo & Tsokos, 2012). It could be appropriate tosubject the patient into the use of antimalarial drugs to help reducethe symptoms she is suffering from. Jane complains of pain andswelling. It can be treated by use of medicines such as ibuprofen andnaproxen. Each of the drugs falls under the category of nonsteroidalanti-inflammatory medications. However, it is essential that thepatient is monitored while taking the drug.
The patient needs to learn how best to manage the condition byherself. It is vital that she comes for follow-up periodically. It isessential that she observes proper nutrition and seeks medical adviceon the use of drugs she has been prescribed with. Physical exerciseis equally effective in helping manage the condition.
Lupus erythematosus remains to be a significant health problem.Patients affected the need to get an earlier diagnosis for effectivetreatment and management. Jane’s condition can be dealt withthrough early intervention. It is essential that she accessesadequate medical treatment to help her cope with the medicalcondition.
Ahmadpoor, P., Dalili, N., & Rostami, M. (2014). An update onpathogenesis of systemic lupus erythematosus. Iranian Journal ofKidney Diseases. http://doi.org/24878938
Bramham, K., Hunt, B. J., Bewley, S., Germain, S., Calatayud, I.,Khamashta, M. A., & Nelson-Piercy, C. (2011). Pregnancy outcomesin systemic lupus erythematosus with and without previous nephritis.Journal of Rheumatology, 38(9), 1906–1913.http://doi.org/10.3899/jrheum.100997
Choi, J., Kim, S. T., & Craft, J. (2012). The pathogenesis ofsystemic lupus erythematosus-an update. Current Opinion inImmunology. http://doi.org/10.1016/j.coi.2012.10.004
Lisnevskaia, L., Murphy, G., & Isenberg, D. (2014). Systemiclupus erythematosus. In The Lancet (Vol. 384, pp. 1878–1888).http://doi.org/10.1016/S0140-6736(14)60128-8
Lo, M. S., & Tsokos, G. C. (2012). Treatment of systemic lupuserythematosus: New advances in targeted therapy. Annals of the NewYork Academy of Sciences, 1247(1), 138–152.http://doi.org/10.1111/j.1749-6632.2011.06263.x