Monday, September 17, 2007

An Overview with Systemic Lupus Erythematosus

The immune system is a combination of specialized blood cells called white blood cells and the chemicals they secrete called the antibodies. The body recognizes foreign cells or organisms, such as viruses and bacteria. It fights them using both white blood cells and antibodies. The white blood cells and antibodies find the foreign material and destroy it by breaking down. The immune system is very good from protecting us from microbes and viruses. Unfortunately, sometimes the immune system mistakes body cells for foreign material, causing the immune system to attack the body itself. This self-destruction causes inflammation and damages various body tissues. When the immune system mistakes the body cells for foreign material, an autoimmune disease results.

Lupus is a condition of chronic inflammation caused by an autoimmune disease. Patients with lupus produce abnormal antibodies in their blood that target tissues within their own body rather than foreign infectious agents. Because the antibodies and accompanying cells of inflammation can involve tissues anywhere in the body, lupus has the potential to affect a variety of areas of the body. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and/or nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).

The precise reason for the abnormal autoimmunity that causes lupus is not known. Inherited genes, viruses, ultraviolet light, and drugs may all play some role. Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis, and immune thyroid disorders are more common among relatives of patients with lupus than the general population. Scientists believe that the immune system in lupus is more easily stimulated by external factors like viruses or ultraviolet light. Sometimes, symptoms of lupus can be precipitated or aggravated by only a brief period of sun exposure.

SLE is the most common form of the disease and can affect anyone at any time but is about eight to ten times more common or about 90% of those diagnosed with SLE are female and is most frequently seen in people who are in their early twenties to mid forties. There is an increased incidence of lupus in persons of African, Asian, Hispanic, and Native American descent.

Symptoms of lupus vary from patient to patient or from time to time for the same patient and this it difficult to diagnose lupus. Patients with SLE can develop different combinations of symptoms and organ involvement.They go through cycles of symptoms, called flares, and periods of wellness called remission. Common complaints and symptoms include fatigue, low-grade fever, loss of appetite, muscle aches, arthritis, ulcers of the mouth and nose, facial rash ("butterfly rash"), unusual sensitivity to sunlight (photosensitivity), inflammation of the lining that surrounds the lung (pleuritis) and the heart (pericarditis), and poor circulation to the fingers and toes with cold exposure (Reynaud’s phenomenon). More serious organ involvement with inflammation occurs in the brain, liver, and kidney. White blood cells and blood clotting factors also can be decreased in SLE, thereby increasing the risk of infection and bleeding. It is also known that some women with SLE can experience worsening of their symptoms prior to their menstrual periods. This phenomenon, together with the female predominance of SLE suggests that female hormones play an important role in the expression of SLE.

As lupus erythematosus is a chronic disease with no known cure, the goal of treatment is to relieve symptoms and protect organs by decreasing inflammation and/or the level of autoimmune activity in the body. Many patients with mild symptoms may need no treatment or only intermittent courses of antiinflammatory medications. Those with more serious illness involving damage to internal organ(s) may require high doses of corticosteroids in combination with other medications that suppress the body's immune system. Patients with SLE need more rest during periods of active disease. During these periods, carefully prescribed exercise is still important to maintain muscle tone and range of motion in the joints.

This study will help the patient understand the factors that predisposed her condition thus helping her modify her lifestyle to prevent aggravation of the disease and relieve signs and symptoms of feeling of fullness associated with Systemic Lupus Erythematosus. The study will also help the patient understand the signs and symptoms associated with Systemic Lupus Erythematosus such as alopecia, anasarca, and kidney infection, thus will help her participate with the interventions designed for her, increasing her compliance to the therapeutic regimen. Moreover, the study will help nursing students increase their understanding of the disease, and be able to correlate the results of diagnostic studies and clinical manifestations with the pathophysiology of the disease. The study will also help students formulate an individualized nursing care plan with appropriate nursing interventions and design a plan of care that will answer the client’s complaint.

That is only if S.L.E. was chosen to be the final case. S.L.E. also has a mix of psychiatric nursing. Unfortunately, my so so group mates were err... "coward" enough to face the very complex and late stage S.L.E.

The world really needs competent nurses who are always ready to face their fears and those who are always willing to learn even from mistakes. It's very depressing to know that only few nowadays has that quality. Well, I guess, money has overwhelmed mission...


L.A said...

Are we like speaking on Medical Terms here? Hehe...

Anyway if thats the case I would be somewhat interested too but...errr baka dead na ang client before we can do all the assessments LOL!

Last case presentation namin was about that fuckin Pott's Disease, nakakaloka yung client ubo ng ubo mahawa pa ako sa sakit nya...hehe

P.S - Kamusta naman ang cheque?

JP aka Elmo said...

off topic muna.

napabilang ka sa isa s mga na-TAG ko.