Al-Hussein Bin Talal University
Princess Aisha Bint Al-Hussein College of Nursing And Health
Sciences
Case Study Presented By : Mays Mousa Khader
Department of Medical Analysis
Systemic Lupus
Erythematosus (SLE)
Contents of the case study
Introduction
Objective
Materials and methods
Results
Conclusion & Recommendation
References
Acknowledgements
Introduction
Systemic lupus erythematosus (SLE) is an autoimmune and multisystemic chronic
inflammatory disease that can affect various organs (Illescas‐Montes et al., 2019).
Onset occurs commonly in women of reproductive age, in the third and fourth decades
of life, with a male:female ratio of about 1:10 (Irure-Ventura & López-Hoyos, 2022).
Genetic predisposition, environmental triggers, and the hormonal milieu, interplay in
disease development and activity (Fava & Petri, 2019).
Adults diagnosed before 50 years of age usually present with cutaneous symptoms
(malar rash) and renal abnormalities (lupus nephritis) (Ameer et al., 2022).
The diagnosis of systemic lupus erythematosus is made based on a combination of
typical clinical manifestations and positive serology (Fava & Petri, 2019).
Patients diagnosed with systemic lupus erythematosus (SLE) often have skin and oral
lesions as part of their presentation (Chiewchengchol et al., 2015).
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content.aspx?chunkiid=19785 signs-symptoms-2018-12
Objective
To know the stage of the disease to determine the mechanism of the treatment.
To increase people's awareness of SLE .
Present a case study and all that it includes in terms of diagnosis and examinations .
Importance of early diagnosis and treatment of the chronic diseases .
Method 1
Patient identification
Name: Volunteer
Age: 25 Years old
Sex: Male
Method 2
• The patient showed these symptoms: fatigue, fever, and a rash when exposed to the
sun.
• The patient wasn't taking any kind of medication.
• There is a family history of SLE.
Method 3
Laboratory tests orders
Test Type of tube Type of sample
CRP Plain Serum
ESR EDTA Whole blood
CBC EDTA Whole blood
PT, PTT, INR Sodium citrate Plasma
Kidney function tests Plain Serum
Serology tests Plain Serum
Urine tests Urine cup Urine
Chemical tests Urine cup Urine
Results1
CBC
Test Result Normal Test Result Normal
Range Range
WBCs 11.6 H (4-11)*10^9/L Neutrophils 86.6 H 40-80 %
Lymphocytes 8.3 L 20-40 %
RBCs 5 (4.3-6)*10^12/L
HGB 14.6 14-17.5 g/dL Monocytes 4.8 2-10 %
HCT 43.1 40-53 % Eosinophil's 1.3 1-6 %
MCV 86.2 80-96 FL
MCH 29.2 28-33 pg
Basophils 0.2 L 1-2 %
MCHC 33.9 33-36 g/dL
RDW 13 11-16 %
Platelet count 234 (150-450)*10^9/L
Results 2
Inflammatory markers Kidney function tests
Test Result Normal
range
CRP 1.7 0-5 mg/L
ESR 25 H 0-15 mm/hr
Coagulation profile
Test Result Normal
range
PT 13 12-16 sec
APTT 35.9 30-40 sec
INR 0.99 0.85-1.15
Chemical test
Results 3
Serology tests
Test Result
ANA Positive ANA: Speckled + Homogenous 1/80
Ref.Ranges:
Anti-dsDNA Positive
Negative: <1/40 Positive:>=1/40
Anti-Smith Negative
RF Negative
Test Result Normal range
Complement 124 80-193 mg/dL
C3
Complement 13.8 L 14-57 mg/dL
C4
Results 4
Urine tests analysis
Chemical
Physical examination: Microscopic exam:
examination:
PH: 6 (Acidity).
Color: Yellow. WBCs:0-2
Specific gravity: 1.010 Normal range:0-4 /HPF
Normal range(1.005-1.030)
Protein: +3.
Character: Clear. RBCs:5-7 H
Glucose: Nill. Normal range:0-3/HPF
Conclusion and Recommendation
Based on the results of the patient’s examinations, it was found that the patient had
(SLE), and it was found through the examinations that there was increased protein in
the urine, which means that the disease affected the patient’s kidneys.
The doctor asked the patient to do a biopsy of the kidneys to make sure that the
disease affected the kidneys.
It was found out from the result of the biopsy the kidney cells are abnormal and the
presence of signs in the kidney tissue indicates the presence of inflammation. The
doctor diagnosed him with lupus nephritis.
Conclusion and recommendation
Treatments
Immunosuppressant (Myfortic).
Prednisolone.
Advaquenil (Hydroxychloroquine sulphate).
Micardis Plus.
The patient conducts laboratory tests every 6
months to ensure that the treatment is correct
and to reduce or increase the dose of medication
according to the effectiveness of the treatment.
Recommendations
See your doctor regularly.
Avoid exposure to sunlight.
Do regular exercise.
Healthy balanced diet.
Avoid using non-steroidal anti-inflammatory drugs that
affect kidney function.
Refernces
1. Ameer, M. A., Chaudhry, H., Mushtaq, J., Khan, O. S., Babar, M., Hashim, T., ... &
Khan, O. S. (2022). An overview of systemic lupus erythematosus (SLE)
pathogenesis, classification, and management.
2. Cureus, 14(10).Chiewchengchol, D., Murphy, R., Edwards, S. W., & Beresford, M.
W. (2015). Mucocutaneous manifestations in juvenile-onset systemic lupus
erythematosus: a review of literature. Pediatric Rheumatology, 13(1), 1-9.
3. Fava, A., & Petri, M. (2019). Systemic lupus erythematosus: diagnosis and clinical
management. Journal of autoimmunity, 96, 1-13.
4. Illescas‐montes, R., Corona‐castro, C. C., Melguizo‐rodríguez, L., Ruiz, C., &
Costela‐ruiz, V. J. (2019). Infectious Processes And Systemic Lupus Erythematosus.
Immunology, 158(3), 153-160.
5. Irure-Ventura, J., & López-Hoyos, M. (2022). Disease criteria of systemic lupus
erythematosus (SLE); the potential role of non-criteria autoantibodies. Journal of
Translational Autoimmunity, 5, 100143.
Acknowledgements
I offer my special thanks to everyone who helped me
and increased my confidence. Thanks to my family
and the doctors in the Medical Analysis Department,
AHU and Al-Bashir Hospital laboratory staff.
Thank you
