Professional Documents
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Lupus is known for autterfly rush on the face. They were first seen in the late 1800.
The discovery of the systemic involvement was first in the late 1800s.
Joint
s lymphatic system
Central nervous system
Neuromuscular
Circulatory system/invovlment
In the early 1900s, the butterfly rash was again seen in 20 patients who also had
systemic involvlement involving the lungs, heart, kidney and brain, which are known
as advanced lupus.
18 of those patients died in two years, whocih lead to the start of research in to this
disorder.
CAUSES
Lupus is multifactorial with no one specific cause. It can be combination of
genetics, enzyme deficiency, hormone deficiency, environmental, chemicals, oral
contraceptives, and over 100 linked drugs.
Lupus is not contagious and is not spread from one person to another..
PATHOPHYSIOLOGY
It is suspected that Gene mutations lead to proliferation of the auto antibodies
leading to inflammation and blood vessel abnormalities. Eventually causing
problems in all systems.
The most widely studied and known about is the kidney concerning
glomerulonephritis. The gene mutations are so been researched, however, it seems
to cause the lymphocyte production to be abnormal. Specificly with increased T
cells. A B-CELL is part of the bodysdefence system to fight against antigens.
However in patients with lupus, for some reasons there is increase production of
abnormal B-CELLS. Which Instead of attacking antigens, they start attacking the
body, which is called autoimmune disorder.
Another contributing factor, is that additoiin to the production of abnormal B-CELLS,
there is also LOW APOPTOSIS of B-CELLS.
APOPTOSIS means a normal process in which a cell dies.
With increase production of abnormal B-CELLS and LOW APOPTOSIS, this causes an
increased amount of abnormal B-Cells.
This auto immune antibody are found in the LAB TEST called ANA DsDNA.
A patient may go a long time without knowing they have lupus due to the general
symptoms.
They may present with general tiredness, or aches and pains.
Proper diagnosis should be performed by a rheumatologist.
SYSTEMS that can be affected include the dermatological system or skin causing
rashes and lesions, The Musculuskeletal System causing pain and inflammation, the
pulmonary system causing pleurisy and or pleural effusion, The Cardiac System
causing mild carditis and or pericardidtis, The Vascular System causing anemia,
leukopenia, thrombocytopenia, and vascularitis. The Renal System causing
glomerulonephritis, acute kidney injury, and potentially kidneychronic disease, The
GastroIntestinal System causing abdominal pain, weight loss,anorexia and nausea,
and finally, The Nerurological System causing potential decrease levels of
consciousness, seizures and psychosis.
DIAGNOSIS
Many lab tests are done and lupus can mimic many other autoimmune disorders.
Some lab test used by rheumatologist can include:
-
AntiNuclear Antibody Testing this is done first which is usually high in lupus
but it can also be high in other disorders.
Other test can include
Erythrocyte Sedimentation Rate
Double stranded DNA antibody assay
ENA PANEL
Extracable nuclear antigens
Ches and Joint Xrays
CT SCANS can also help the diagnosis.
Also BIOPSIES of appropriate to organs may be necessary to confirm
diagnosis.
PATIENT EDUCATION
1. Patient s are told to avoid direct sunlight , it can cause exacerbation in all
systems. If they must go in the sunlight though, instruct them to use atleast
30+ SPFsunscreen in addition to clothing.
2. Teach non pharmacological stress reduction thecniques. Also to tach to stay
active with mild exercise during times when there is no flare up to maintain
joint function and to keep mucle mass. Also teach osteoporosis prevention as
well as joint care proper exercise and possible supplementation with vitamins
such as LOCOSAMIN?
3. Instruct maintain a diet low in salt and fat and to avoid elevated blood
pressure
4. Overall, encourage eating healthy foods
5. And in caution about being around populations that are easily get sick
6. Also teach to avoid infection by washing hands frequently
7. And be vigilant in looking for the early sign and symtoms of infections
8. Encourage in full support in
9. Encourage communication with a psychologist or psychiatrist to help cope
with the stress as needed.
10.Also instruct your patient to prevent infectioin by staying up to date with
immunizations including the yearly flu shot and pap smear.
Now lets go to QUESTIONS
1. Which of these are risk factors for lupus? Select all that apply
a. Genetics
b. Being of European decent
c. Having a stepmother with lupus
d. Having a brother with lupus
e. Being in middle school
f. Being a male
2.