Lecture on Arthritis and Connective Tissue Diseases: Lupus and Fibromyalgia

Introduction

• Focus on the musculoskeletal system diseases: lupus and fibromyalgia.
• Importance of connective tissues in the body.
• Lupus and fibromyalgia as diseases affecting these systems.

Lupus

Overview

• Autoimmune disease affecting connective tissue throughout the body.
• Predominantly affects women of childbearing age.
• Affects multiple systems: skin, joints, kidneys, heart, lungs, brain, and blood.

Causes

• Genetic, hormonal, infectious (e.g. Epstein-Barr virus), environmental factors.
• Development of specific antibodies like anti-nuclear antibodies (ANA).
• Complexes deposit in capillary membranes leading to organ damage.

Symptoms and Effects

• Skin: Butterfly rash, discoid lupus (ring-shaped lesions), oral ulcers, hair loss.
• Musculoskeletal: Bilateral joint pain, swelling, stiffness, deformities similar to rheumatoid arthritis.
• Cardiac: Cardiomyopathy, endocarditis, pericarditis, Raynaud’s phenomenon.
• Respiratory: Pleurisy, dyspnea, cough, impaired gas exchange.
• Hematological: Anemia, leukopenia, thrombocytopenia, hypercoagulability.
• Renal: Lupus nephritis, potential renal failure.
• Neurological: Neuropsychiatric issues, seizures, headaches, behavioral changes.

Diagnosis

• Blood tests: ANA, anti-DNA, anti-Smith bodies, anti-phospholipid antibodies.
• Monitoring ESR and CRP for inflammation.

Treatment

• Medication types: NSAIDs, antimalarials (e.g. hydroxychloroquine), corticosteroids, immunosuppressants.
• Manage medication side effects carefully.

Nursing Process

• Assessment: Flare-ups, daily functioning, symptoms like fever, inflammation, renal symptoms.
• Goals: Manage symptoms, maintain function, prevent organ damage.

Fibromyalgia

Overview

• Characterized by muscle pain and non-articular pain.
• Involves tender points along muscles.
• More common in middle-aged women.

Causes and Theories

• Abnormal processing of pain receptors in the central nervous system.
• Genetic predispositions, autoimmune diseases, infections may increase risk.

Symptoms

• Widespread muscle pain, fatigue, sleep disturbances.
• Cognitive symptoms: "Brain fog," stress sensitivity, headaches.
• IBS, neurological symptoms like paresthesias.

Diagnosis

• Based on symptoms criteria: tender points, long-lasting, widespread pain.

Treatment

• Medications: Neurotransmitter modulators (e.g. pregabalin, Cymbalta).
• Muscle relaxants, sleep aids.
• Non-pharmacological approaches: Gentle exercise, yoga, tai chi, dietary modifications.
• Supportive therapies: Biofeedback, meditation, massage.

Conclusion

• Importance of early diagnosis and management.
• Support systems for patients and families.
• Collaborative care and education to improve quality of life.