A 43-year-old man presented in the primary care clinic with chief… A 43-year-old man pres
A 43-year-old man presented in the primary care clinic with chief… A 43-year-old man presented in the primary care clinic with chief complaints of painful, stiff knees and hand joints of 4-5 weeks. He denies any history of Raynaud’s phenomenon. He had bilateral mild-moderate swelling in both knees and hand joints on examination. He had an on and off skin rash on the anterior neck. He also gets occasional generalized muscle tenderness. His U/A showed no proteinuria, and he denied any episode of fever. The results of relevant investigations are shown in the table below. Case Study: Lab ResultsC-reactive protein7mg/l (normal)Rheumatoid factorNegativeAntinuclear antibody titerPositive (titre 1/90; IgG class)dsDNA-binding activity75% (NR 0-30% binding)Antibodies to extractable nuclear antigensNegativeSerum complement levels C30.35g/l (NR 0.65-1.30) C40.60g/l (NR 0.20-0.50)Serum immunoglobulins IgG170.0mg/dl (NR 72-190) IgA45mg/dl (NR 20-50) IgMBasic chemistry18mg/dl (NR 5-20)Na, K, Glucose, Ca were normal, and BUN 19 mg/dL and Creatinine 1.1 mg/dLBiopsy of normal, sun-exposed skin (lupus band test)Granular deposits of IgG and IgA immunoglobulins and complement four along the epidermal basement membrane Instructions: Answer all questions.1. What is your diagnosis for this patient? What are your differential diagnoses? 2. How would you treat this patient? Support your answer with a recent journal publication. 3. Please give at least three conditions/diseases of autoimmunity AND describe the pathophysiologic features of each disease. 4. What are the eleven common findings/clinical manifestations of systemic lupus erythematosus? How many of these signs and symptoms should be present to indicate SLE? Health Science Science Nursing NSG 428 Share QuestionEmailCopy link Comments (0)
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