Immunity - Altered Immune Response.pdf

Premier Access for Applied Pathophysiology for the Advanced Practice Nurse, 2e (Open Enrollment) ISBN 9781284255751 CHAPTER 2 Immunity Altered Immune Response criteria continue to evolve in attempts to obtain a universal consensus. Some...

Premier Access for Applied Pathophysiology for the Advanced Practice Nurse, 2e (Open Enrollment) ISBN 9781284255751 CHAPTER 2 Immunity Altered Immune Response criteria continue to evolve in attempts to obtain a universal consensus. Some 95 patients suspected of having SLE may never develop enough of the criteria to qualify for a definite diagnosis; other patients accumulate enough criteria to merit SLE diagnosis only after months or years. When a person has four or more of the criteria, the diagnosis of SLE is strongly suggested. When evaluating a patient, these criteria can be used in patients presenting with common SLE symptoms (see Table 2- 6) although some are vague (e.g., fatigue, fever) and can be present in many other disorders. Clinical Criteria for SLE Diagnosis Skin: acute/subacute cutaneous—Malar rash (“butterfly” rash over the cheeks of the face), photosensitivity; chronic cutaneous lesions—(e.g., discoid lupus—rough, scaly, raised, red circular) Oral ulcers—look like aphthous ulcer (i.e., cold sore) but can also be in nose Alopecia—usually patchy Synovitis—joint inflammation causes pain, swelling usually symmetric, two or more joints and can migrate Serositis (inflammation of the serous membranes that line the lungs [pleura], heart [pericardium], and inner abdomen [peritoneum]) Hemolytic anemia Leukopenia (