How to write a discussion essay on RHEUMATOID ARTHRITIS

Q1. Describe the immunogenesis of the joint changes that occur in RA

Adults are more likely to develop RA, a chronic inflammatory systemic illness that causes changes in the synovial membrane, periarticular structures, skeletal muscles, and perineural sheath that are both destructive and proliferative (Weyand & Goronzy, 2020). Progression of the disease leads to deformities, destruction, and ankylosis. Immunogenic responses occurring at the synovium are attributed to RA. The cells lead to autoantibody formations, T-cells activation, antigen presentation, and cytokine production. Activated T cells consequently activate B cells directly or via proinflammatory mediators, which then differentiate into antibody-producing plasma cells. Proinflammatory cells produced by activated B cells include IL—6, lymphotoxin, and TNF alpha, which causes the systemic manifestations of RA (Weyand & Goronzy, 2020). Both RF and anti-CCP antibodies form immune complexes that activate complement and attract other inflammatory cells to the synovium.

Q2. What Is The Significance Of Her RF Results?

The rheumatoid factor test measures the amount of RF in the blood. It is used to aid in diagnosing RA and other immune-complex diseases. Also, to identify the severity and whether nearby organs or tissues are affected. Rheumatoid factor is an antibody common in individuals with RA; however, it is not specific to the condition because it is associated with another immune disease (Tiwari et al., 2020). The normal RF ranges between   0-20 IU/ml. The patient has an RF level of 120 IU/ml, thus positive RF. Laboratory investigations such as ESR, CRP, and X-rays combined with the clinical manifestations will aid in making a definitive diagnosis of RA.

 

1. How Do Her Complaints Of General Fatigue And Weight Loss Relates To The Ra Disease Process?

Proinflammatory cytokines such as IL-6 and TNF-α damage the joints by initiating inflammation, pain, stiffness, muscle weakness, and exhaustion. According to Kreps et al. (2018), changes in physical activity, diet, and disease progression is a causative factor of weight loss in RA patients.

 

References

Kreps, D. J., Halperin, F., Desai, S. P., Zhang, Z. Z., Losina, E., Olson, A. T., Karlson, E. W., Bermas, B. L., & Sparks, J. A. (2018). Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data. International Journal of Clinical Rheumatology, 13(1). https://doi.org/10.4172/1758-4272.1000154

Tiwari, V., Jandu, J. S., & Bergman, M. J. (2020). Rheumatoid Factor. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532898/

Weyand, C. M., & Goronzy, J. J. (2020). The immunology of rheumatoid arthritis. Nature Immunology, 22(1), 10–18. https://doi.org/10.1038/s41590-020-00816-x

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