Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder that is long-lasting and primarily affects the joints. It normally results in swollen, warm, and painful joints. The condition worsens after a rest. The wrist and the hands are commonly involved with the same joints on both sides of the body. The disease may at times affect other parts of the body resulting in inflammation around the lungs, low red blood cells and inflammation around the heart.


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Sample Rheumatoid Arthritis Essay

Type: Assignments
Subject: Pathophysiology
Subject area: Nursing
Education Level: Masters Program
Length: 2 pages
Referencing style: APA
Preferred English: US English
Spacing Option: Double
Title: Altered Physiology
Instructions: a 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever. patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every friday morning and prednisone 5 mg po qam. he states that he has had a fever up to 101 degrees f for about a week and admits to chills and sweats. he says he has had more fatigue than usual and reports some chest pain associated with coughing. he admits to having occasional episodes of hemoptysis. he works as a grain inspector at a large farm cooperative. after extensive work-up, the patient was diagnosed with invasive aspergillosis. be sure that your paper is no one than 1-2 content pages. you are to also include both a title page and a reference page. no more than 1-2 content pages. the assignment (1- to 2-page case study analysis) develop a 1- to 2-page case study analysis in which you: explain why you think the patient presented the symptoms described. identify the genes that may be associated with the development of the disease. explain the process of immunosuppression and the effect it has on body systems.

Altered Physiology

Introduction

There is a significant increase in the number of chronic conditions globally. These conditions significantly affect the quality of life of various individuals, thereby limiting their productivity by causing functional impairments. Besides, specific factors could be intrapersonal or environmental, which increase an individual’s risk of developing a particular condition. Unfortunately, some of the treatment modalities available for managing the various chronic conditions, such as radio chemotherapy and immunosuppressants in cancer and autoimmune diseases, respectively, have significant adverse impacts on the health status and well-being of the patients. This paper analyzes the case study provided of a patient with rheumatoid arthritis who is on medications and presents with symptoms; upon investigation, it reveals that the patient has developed invasive aspergillosis. 

Why the Patient Presented the Symptoms Described

Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints. It is considered an autoimmune condition, and treatment is often targeted at reducing the immune response. The patient is on methotrexate, an immune modulator, and prednisone, an anti-inflammatory medication. The two drugs are used in managing rheumatoid arthritis since they suppress the immune system (Bullock et al., 2018). The patient's symptoms point toward an infection, although some, such as fever and chills, could be due to methotrexate side effects (Bullock et al., 2018). Therefore, the patient is on these drugs implies that their immune system function is impaired, hence at risk of developing infections. 

Given his immunocompromised state, working as a grain inspector poses a significant risk to this patient. The symptoms are, therefore, attributable to an opportunistic infection as revealed by the diagnosis, which could, however, not be capable of causing disease in individuals with well-functioning immune systems. It is therefore worth noting that the patient presented with the symptoms because of an infection, which occurred due to the immunocompromised state of his immune system, which resulted from the immunosuppressant medications he was taking for rheumatoid arthritis. 

Genes Associated With the Development of the Disease

Genetics plays a critical role in the development of various conditions. This explains the basis of some diseases being common within a specific family. Studies also reveal an increased risk of developing rheumatoid arthritis following the inheritance of a particular gene that results in the immune system attacking the body's healthy tissues in the joints (Okada et al., 2019). This is further confirmed by the increased risk of developing rheumatoid arthritis among siblings and even higher risk in identical twins. Some of the genes which have been found to increase the risk of developing rheumatoid arthritis include; HLA-DRB1, which is responsible for antigen presentation, and PTPN22, which is responsible for the activation of the T- cells. Others are; STAT4, which is key in T-cell differentiation, TRAF1-C5, which is responsible for complement activation or TNF signaling; and CD40, which drives autoantibody production (Okada et al., 2019). 

Process of Immunosuppression and the Effect on Body Systems

Immunosuppression occurs when there is a reduction in the immune system's activation or efficacy. This could either occur by the immune system itself, where a portion of the immune system has immunosuppressant activity on other parts, or as a result of external factors such as drug-induced or following radiotherapy, or due to infections targeting the immune cells such as HIV/AIDS (Brod, 2020). The immune system is a well-coordinated system that shuts down its system once the response is complete and the infection has been cleared. Autoimmune diseases occur when immunosuppression is lacking, and the immune system attacks itself (Brod, 2020). The drugs used to manage these diseases, therefore, target the immune system to lower their response so as o prevent attacks on the body's cells. Immunosuppression makes the various body systems vulnerable to infections, thus affecting their ability to function properly and efficiently (Brod, 2020). 

Conclusion

The autoimmune disease poses significant challenges to the patients. The challenges are witnessed even during the treatment when the available treatment options could expose the patient to other infections due to an immunocompromised state. It is, therefore, essential to properly evaluate the patient's medical history and conduct regular assessments to address the infections as early as possible. 

References

Brod, S. A. (2020). In MS: immunosuppression is passé. Multiple Sclerosis and Related Disorders40, 101967. https://www.sciencedirect.com/science/article/pii/S2211034820300432 

Bullock, J., Rizvi, S. A., Saleh, A. M., Ahmed, S. S., Do, D. P., Ansari, R. A., & Ahmed, J. (2018). Rheumatoid arthritis: a brief overview of the treatment. Medical Principles and Practice27(6), 501-507. https://www.karger.com/Article/Abstract/493390 

Okada, Y., Eyre, S., Suzuki, A., Kochi, Y., & Yamamoto, K. (2019). Genetics of rheumatoid arthritis: 2018 status. Annals of the rheumatic diseases78(4), 446-453. https://ard.bmj.com/content/78/4/446.abstract 

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