Rheumatoid Arthritis (RA) -Case Study
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Rheumatoid Arthritis (RA) -Case Study
Evaluation of the clinical manifestation
In this case, the patient has rheumatoid arthritis (RA) which is an ongoing inflammatory autoimmune issue that usually impacts the joints, and sometimes it affects the tissues as well the organ systems. From the case, we are also told that the patient gets methotrexate as well as prednisone to manage the disease. In this case, the fever that the inflammation process of the RA causes the patient experiences. This fever is a major caused by a systemic release of cytokines (interleukin-1 or interleukin-6) which once released becomes pyrogens which then triggers the hypothalamus to increase the temperature of the body. Moreover, the Chills, as well as the sweats, are considered the thermoregulation mechanisms. The patient experience Chills because it is a response to the immediate decrease in the temperature of the body which in turn triggers the body via involuntary muscle contraction, producing heat that increases the temperature of the body. Therefore, when the body becomes hot (temperature rises), Sweats are released for cooling purposes once the hypothalamus detects the temperature of the body to be too high.
RA starts with general appearances of inflammation such as fever, fatigue, weakness, weight loss, among other primary symptoms (Tracey, 2017). The initial impression of fatigue incorporates multifocal aetiology that might include worsening of severe, lasting RA inflammatory developments, fatigue that is as a result of coughing, as well as new provocative developments related to the invasive aspergillosis. Generally, the (IA) grows in the lung’s alveoli and then prevents the optimal functioning of the lungs, resulting in the production of dry cough, difficulties in breathing, chest pain, and sporadic occurrence of hemoptysis.
Genes Associated with Disease Development
Genetic, as well as environmental aspects, generally cause rheumatoid arthritis. The human leukocyte antigen gene (HLA) working in the immune system distinguishes the protein of the body from that one of the foreign invaders. According to research, the alterations in the HLA genes the HLA-DRB1 gene is the major genetic risk factor that results in the development of the RA. RA further attacks the lungs, just as indicated by the given case of the 49-year old patient. When the Rheumatoid nodules move to the lungs, it causes pulmonary fibrosis which in turn decreases the elasticity of the lung, and this permits the inhaled particulates to be deposited. Research have also determined sex, age, as well as the environment to be other Risk factors for RA (Xu & Lin, 2017). The risk of getting RA rises as age increases; however, women are riskier as compared to men (Xu & Lin, 2017). Moreover, Smoking, various environmental factors are also contributing factors to the development of RA.
Process of Immunosuppression and its Impacts
In the case of RA, the antibodies are produced by the body to fight self-antigens, causing joint injuries, tissue injuries as well as organ injuries. Immunosuppressive therapy is considered the best care standard currently, and this includes the utilization of the methotrexate, prednisone et cetera. Methotrexate help in suppressing the inflammatory developments through reduction of the cell aggregation, alterations of the T-helper cell activity, as well as inhibitions of cytokine production, this then helps in reducing the RA damage. On the other hand, prednisone is critical in suppressing the inflammatory as well as modification of the typical response of the immune (Vallerand & Sanoski, 2020). Therefore, once the normal functioning of the immune system is altered, then there is invasion by the opportunistic pathogen resulting in the Invasive aspergillosis as highlighted in the case of the 49-year old patient.
References
Tracey, G. (2017). Diagnosis and management of rheumatoid arthritis. Prescriber, 28(6), 13-18. doi:10.1002/psb.1580
Vallerand, A. H., & Sanoski, C. A. (2020). Davis’s drug guide for nurses. F.A. Davis.
Xu, B., & Lin, J. (2017). Characteristics and risk factors of rheumatoid arthritis in the United States: An NHANES analysis. PeerJ, 5, e4035. doi:10.7717/peerj.4035