Case Study 1 Systemic Lupus Erythematosus, Case Study 2 AIDS
Mosby’s Manual of Diagnostic and Laboratory Tests, 5th Edition
Systemic Lupus Erythematosus
Case Studies
A 24-year-old woman had been complaining of multiple joint and muscular pains and
stiffness in the morning. She also noted some hair loss and increased skin sensitivity to light.
Her physical examination showed slight erythema around the cheek bones and some swelling in the joints of her hands.
Studies Results
Routine laboratory work Within normal limits , except for mild
anemia
Urinalysis, p. 956 Profuse proteinuria and cellular casts
Antinuclear antibody , p. 88 1:256
Anti-ENA Positive
The positive ANA and ACA tests strongly supported the diagnosis of systemic lupus erythematosus . The patient also had a facial rash suggestive of SLE. The elevated ESR indicated a systemic inflammatory process. The immunoelectrophoresis results were compatible with either RA or SLE; however, a decreased complement assay is commonly associated with SLE. The abnormal urinalysis indicated that the kidneys also were involved with the disease process. The patient was treated with steroids and did well for 7 years.
Unfortunately, her renal function deteriorated, and she required chronic renal dialysis.
Critical Thinking Questions
1. Explain the significance of the urinalysis results as they relate to renal involvement with SLE.
2. Why is the ESR increased in inflammatory conditions?
