Case Study For Altered Physiology Discussion

Case Study For Altered Physiology Discussion

The Assignment

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.
By Day 7 of Week 2
Submit your Case Study Analysis Assignment by Day 7 of Week 2. Case Study For Altered Physiology Discussion

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Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templatesLinks to an external site.). All papers submitted must use this formatting.

Case: A 24-year-old male presents to the clinic with a chief complaint of developing large areas of dandruff to his scalp and pitting of his fingernails. He also started noticing that he is having morning joint pain that partially relieves after he gets ready for work. He has used multiple types of dandruff shampoo without relief of symptoms. He is unable to remember any significant family history concerns. Labs include a rheumatoid factor which was negative. His ESR was mildly elevated Case Study For Altered Physiology Discussion

The case study involves a 24-year-old male patient who presents to the clinic with complaint of large sections with dandruff on his scalp and pitting on his fingernails. He has also been having morning join paint that is only partially relieved after he prepares to go for work.

Possible Diagnosis

Based on the patient’s presentation of dandruff, nail pitting, joint pain in the morning, and mildly elevated ESR, the most likely diagnosis is psoriatic arthritis, which is likely to have developed from psoriasis. According to Azuaga et al. (2023), it is a chronic inflammatory immune-mediated skin disease that involves erythematous and scaly plaque but tends to also affect the scalp and nails, with approximately 30% of the patients developing psoriatic arthritis. Psoriatic arthritis is a condition that integrates aspects of psoriasis and inflammatory arthritis. In this case, the presentation of dandruff on the scalp is highly likely to be psoriatic plaques, especially due to their resistance to the typical dandruff treatment. In their study, Akaishi et al. (2020) noted that psoriatic arthritis presents with enthesitis or inflammation of the entheses or regions where tendons or ligaments are inserted into bones. The symptoms of nails are a major distinguishing factor in psoriatic arthritis, differentiating it from other types of inflammatory arthritis. The mildly elevated erythrocyte sedimentation rate (ESR) is a likely indicator of the presence of systemic inflammation, which is suggestive of an active psoriatic disease. Case Study For Altered Physiology Discussion

Genes Associated with Development of the Disease

There are several genes that have been associated with the increased risk of developing psoriatic arthritis. According to Patel et al. (2023), the gene that is strongly linked to heightened risk for developing psoriasis and psoriatic arthritis is HLA-C*06:02. This gene has been involved in antigen presentation to T cells. Other genes that are associated with the development of psoriasis are the interleukins, which are cytokines that play critical in the differentiation, proliferation, migration, and adhesion of maturation of immune cells. Among the interleukins that are pro-inflammatory mediators and contribute to psoriasis are IL1B, IL2, IL6, IL12, IL15, IL17, IL18, and IL20 (Patel et al., 2023). The IL1B encodes a cytokine that is generated and serves a critical role in the inflammatory response. Another major inflammatory cytokine noted to cause elevation in psoriasis is the tumor necrosis factor α (TNF-α) that binds to certain receptors and stimulates the nuclear element factor kappa B, and in so doing, leads to rapid transcription of other inflammatory genes, including IL-6 and IL-8. Case Study For Altered Physiology Discussion

Process of Immunosuppression and Effect on Body Systems

Immunosuppression is a process that minimizes the activity of the immune system. This system is used in the treatment of autoimmune diseases such as psoriasis. Immunosuppression is used to target immune cells and can directly target immune cells such as T cells and B cells, thereby their ability to attack the body’s own tissue. Immunosuppression may also work by blocking the production of activity of cytokines, signal molecules that assist in the regulation of immune response. As a therapy for psoriatic arthritis, immunosuppression reduces the hyperproliferation of keratinocytes and infiltration of the skin, which helps address the psoriatic plaques. The immunosuppression treatments reduce synovial inflammation, pain, and swelling and, in so doing, minimize the progression of joint damage. By reducing systemic inflammation, immunosuppression helps mitigate the increased cardiovascular risk due to psoriatic arthritis. Case Study For Altered Physiology Discussion

References

Akaishi, T., Yamasaki, K., Mori, Y., Takahashi, T., Izumiyama, T., Terui, H., … & Ishii, T. (2020). Psoriatic arthritis with skin lesions localized to the scalp: A case report. Journal of General and Family Medicine, 21(6), 264-267. https://doi.org/10.1002/jgf2.358

Azuaga, A. B., Ramírez, J., & Cañete, J. D. (2023). Psoriatic arthritis: pathogenesis and targeted therapies. International journal of molecular sciences, 24(5), 4901. https://doi.org/10.3390/ijms24054901

Patel, H. A., Revankar, R. R., Pedroza, S. T., Graham, S., & Feldman, S. R. (2023). The genetic susceptibility to psoriasis and the relationship of linked genes to our treatment options. International Journal of Molecular Sciences, 24(15), 12310. https://doi.org/10.3390/ijms241512310 Case Study For Altered Physiology Discussion

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Saleem, S., Imran, Z., Samdani, A., Khoso, B., Zehra, S., & Azhar, A. (2023). Mutations in PGRN gene associated with the risk of psoriasis in Pakistan: a case-control study. BMC Medical Genomics, 16(1), 335. https://doi.org/10.1186/s12920-023-01757-8

Xiao, Q., Mears, J., Nathan, A., Ishigaki, K., Baglaenko, Y., Lim, N., … & Raychaudhuri, S. (2023). Immunosuppression causes dynamic changes in the expression of QTLs in psoriatic skin. Nature communications, 14(1), 6268. https://doi.org/10.1038/s41467-023-41984-2 Case Study For Altered Physiology Discussion