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Systemic Lupus Erethematotus - Essay Example

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Systemic Lupus Erethematotus

DISEASE DESCRIPTION Pathophysiology SLE is a chronic, inflammatory, prototypic, systemic autoimmune disease affecting connective tissues such as skin, joints along with kidney and serosal membranes. Researches available indicate an environmental cause, which leads to development of the disease in individuals genetically predisposed and therefore vulnerable to it. However, the disease epidemiology is incompletely understood (Rahman & Isenberg, 2008). The disease involves the production of IgG autoantibodies that are specific for self antigens including DNA, nuclear proteins as well as cytoplasmic components. The disease therefore is characterized by inflammation, vasuclitis, vasculopathy. Further, a deposition of the immune complex especially in the renal glomeruli leads to a systemic inflammatory response through activation of complement (C5), or of Fc{gamma}R-mediated neutrophil and macrophages. While the activation of former leads to formation of membrane attack complexes (C5b-9) or anaphylatoxin and cell activator C5a; that of latter causes release of oxidants and proteases; both leading to injury (KEGG, 2009). The mechanism of the disease development has been proposed to involve an abnormal apoptosis followed by elevated levels of cell death and immune intolerance. Cellular antigen redistribution to the cell surface coupled with lymphocytes targeting them leads to injury and inflammation (Andrade et al., 2000). Treatment Diagnosis of SLE is based on the detection of high levels of antinuclear and other antibodies in the blood along with symptoms of SLE. The techniques used for the detection include urinalysis, CBC, ESR, complement levels, ANA (antinuclear antibody test) and other antibody tests, skin and kidney biopsy along with quarterly follow ups. The treatment involves control of disease symptoms and is determined by the severity of the symptoms. Acute SLE involving CNS, cardiovascular and renal diseases are treated with high doses of intravenous steroids and cytotoxic therapy involving corticosteroids, immunosuppresives, antimalarials, and antipsychotic medication (D’Cruz, 2006). Prognosis Early detection is the key factor in improved prognosis of SLE. Prognosis in severe cases too has shown marked improvement during the recent years as a consequence of aggressive treatments available. Common complications associated with SLE include deep vein thrombosis, pulmonary embolism, hemolytic anemia, pericarditis, endocarditis, myocarditis etc (Makover, 2011). Health Disparity SLE exhibits high correlation with women of child bearing age and therefore has been associated with exogenous hormone intake (Costenbader et al., 2007). Lower socioeconomic status further has been linked to higher disease prevalence as well as resultant mortality. Prevalence and Epidemiology The National Arthritis Data Working Group reports that approximately 250,000 Americans have SLE, the worldwide prevalence rates vary with race, being higher in people with African and Asian origins. The disease is more common in the female sex and in individuals within the age group of 20-40yrs. (D’Cruz, 2006). Organizational Description of the Facility The ER, Fast Track, department known as Rapid Medical Screening (RMS) clinic, of the Medical Center of Central Georgia (MCCG), is where I am currently doing my clinical practicum. ...Show more

Summary

SYSTEMIC LUPUS ERYTHEMATOSUS INTRODUCTION Systemic Lupus Erythematosus (SLE), Disseminated lupus erythematosus, Discoid lupus or lupus is a remarkable disease in many aspects; the primary being it is not a single but a protean disease, affecting almost every organ of the body…
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