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Case study

Student more review of case study and answer all questions with scholarly response APA and include 2 scholarly references. 3 pages

The answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy and paste or use past student work as all files submitted in this course are registered and saved in turn in program.

Turn it in score must be less than 15% or will not be accepted for credit must be in your own words. Copy pastes for website or textbooks will not be accepted or tolerated

All the answers to case studies must-have reference cited in the text for each answer and the minimum of 2 scholarly references (journal or books) Not websites per case study

Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 5th Edition

Systemic Lupus Erythematosus (SLE)

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



Routine laboratory work

Within normal limits (WNL), except for mild anemia

Urinalysis, p. 956

Profuse proteinuria and cellular casts

Antinuclear antibody (ANA), p. 88

1:256 (normal: <1:20)


398 units (normal: <70 units)


Positive (normal: negative)

Anticardiolipin antibody (ACA), p. 68

Immunoglobulin (Ig) G

96 g/L (normal: <23 g/L)


78 mg/L (normal: <11 mg/L)

Erythrocyte sedimentation rate (ESR), p. 221

75 mm/hour (normal: ≤20 mm/hour)

Immunoglobulin electrophoresis, p. 312


1910 mg/dL (normal: 565-1765 mg/dL)


450 mg/dL (normal: 85-385 mg/dL)


475 mg/dL (normal: 55-375 mg/dL)

Total complement assay, p. 172

22 hemolytic units/mL (normal: 41-90 hemolytic units/mL)

Diagnostic Analysis

The positive ANA and ACA tests strongly supported the diagnosis of systemic lupus erythematosus (SLE). The patient also had a facial rash suggestive of SLE. The elevated ESR indicated a systemic inflammatory process. The immunoelectrophoretic 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?