Lupus
Systemic Lupus Erythematosus simply known as Lupus is a chronic autoimmune disorder. It is a disease of challenging nature due to its unknown etiology. Also, it can affect people of all ages and may affect any organ or system of the body. It is characterized by flares and remissions. The etiology of SLE include both genetic and environmental components with female sex more susceptible. Environmental factors of SLE are the following: Ultraviolet light, demethylating drugs and infectious or endogenous viruses or viral like elements (Bertsias, Cervera, & Boumpas, 2012).
SLE involves the humoral and cellular aspects of the innate and acquired immune systems. Autoimmune reactions are directed against the DNA of the cell. Autoantibodies are produced against the nuclear antigens, cytoplasmic antigens, and blood cell surface antigens. Complement activation occurs as these autoantibodies bind to specific antigens. Within the blood vessel walls, immune accumulation of immune complexes occurs. Ischemia within the blood vessel walls will lead the internal lining of the walls to be thickened. There is also the degeneration of fibrinoid and and thrombus formation. Depending on the cell types or the organs involved, specific manifestations of SLE occur. The manifestations can range from alopecia to kidney and brain disorders (Trethewey, 2004).
Diagnosis
Polymyalgia Rheumatica
Treatment
Treatment of PMR involves medication to alleviate the symptoms. Oral corticosteroids such as prednisone are given at low doses. At the beginning of treatment, a daily dose is usually from 12 to 25 mg a day. Within the first two to three days, there will be relief from pain and stiffness. The physician may refer the patient to a specialist, a rheumatologist if the patient is not responding to treatment. For the long-term use of corticosteroids, monitoring of side-effects is important. The possible side effects include: increase in weight, hypertension, osteoporosis, diabetes and cataracts. Calcium and Vitamin D supplements are prescribed to reduce the bone loss by the corticosteroid. A pneumonia vaccine may be suggested by the doctor if the patient is taking 20 milligrams or more of oral corticosteroid a day. Methotrexate is an immune-suppressing medication given to patients in relapse or don’t respond to corticosteroids. Physical therapy might be recommended to patients who suffer from limitations in activity due to polymyalgia rheumatica ("Polymyalgia rheumatica Treatments and drugs", 2015).
The prognosis for patients with isolated polymyalgia rheumatic is good. Medications should be given gradually and not rapidly. Tapering should be done to avoid unwanted flare-ups of the disease.
Reference
Bertsias, G., Cervera, R., & Boumpas, D. (2012). Systemic Lupus Erythematosus: Pathogenesis and Clinical Features (1st ed.). Retrieved from http://www.eular.org/myuploaddata/files/sample%20chapter20_mod%2017.pdf
Polymyalgia rheumatica Treatments and drugs. (2015). Mayoclinic.org. Retrieved 29 May 2016, from http://www.mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/basics/treatment/con-20023162
Trethewey, P. (2004). Systemic Lupus Erythematosus. Dimensions Of Critical Care Nursing, 23(3), 111-115. Retrieved from http://journals.lww.com/dccnjournal/Fulltext/2004/05000/Systemic_Lupus_Erythematosus.3.aspx
