Question

Case Study

A 40-year-old female is seen in the dermatologist's office, upon the recommendation of her internist, for a workup for suspected SLE. Her presenting symptoms include erythema rash across her cheeks and nose, photosentivity resulting in raised rash in sun-exposed areas, patches of alopecia, and pain and stiffness in her joints. The dermatologists examines the patient and orders exfoliative cystology and fungal scrapings to rule out other sources of the rash. Her internist had already placed the patient an oral anti-inflammatory medication for joint pain. The dermatologists orders corticosteroid cream for the rash. The patient is advised to use a sunscreen and make a follow-up appointment for results of the biopsy.

1. What pathological condition does the internist think this patient might have? Look this condition up in a referrnce source, and include a short description of it. SLE is an autoimmune disease. Use a reference source to look up the name of another autoimmune disease.

2. List and define each of the patient's presenting symptoms in your own words.

3. What diagnostic tests did the dermatologist perforn? Describe it in your own words. Why were they important in helping the dermatologist make a diagnosis?

4. Each physician initiated a treatment. Describe them in your own words.

5. What do you think the term "workup" means?

Answer 1

The affected by SLE is females. Mostly between 15 to 45 years of age.

Pathological condition is that the patients own antibodies will react aganist the normal tissues of the body in various places. Formation of anti nuclear antibody will happen and this cause inflammation.

These symptoms will also have when a patient having rheumatoid arthritis.. So the internist will thinking to rule out this disease.

2 The symptoms include joint stiffness and pain. Rashes will happen on the skin especially on the face and it is called as butterfly rashes same like this patient has. Alopecia, hair thinning and hair loss may also happen. Head ache can be happen to some patients. Dryness to mouth and ulcer formation will occour. Coagulation problems to blood and anemia can be occour.

3 main diagnosis includes the antibody testing( anti nuclear antibody). Chest xray will done. Butterfly rash is the main symptom. Urine analysis and complete blood count will be done..

Also checking the inflammation markers like ESR., CRP can be analysed.

Body fluid analysis is done like CSF and joint fluid.

Then biopsy (kidney, skin and nerve )can be done.

4 the main treatment of the SLE is symptomatic treatment.No other proper management is found till now. So the doctors will give medication for the symptoms related to their expertise and refer to another doctor for other symptoms.  

5 with the presence of the symptoms we cant confirm that the condition is SLE. We needs more investigation to find out the disease. After a lot of investigation only we will make up a confirmation that the disease is SLE. So detailed check ups are needed. While the mean time symptomatic treatment also be given. These process is the word means "workup"..