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Differential Diagnosis and Treatment of an Autoimmune Response



Co Authors:

Alisa J. Petree
Medical Laboratory Technician Program
McLennan Community College
apetree@mclennan.edu

Sondra A. Dubowsky
Biology Department
McLennan Community College
sdubowsky@mclennan.edu

Mary A. Sides
Biology Department
McLennan Community College
msides@mclennan.edu

Abstract:

There are a number of medical disorders that mimic each other and accordingly prove problematic for diagnosis, including autoimmune disorders (rheumatoid arthritis and systemic lupus erythematosus), bacterial infections (syphilis), and arthropod borne parasitic infections (Lyme disease). This interrupted case study was designed to familiarize students with the various types of laboratory tests used to differentiate and diagnose such diseases. The storyline follows "Jamie," a biology graduate student, as she experiences a variety of disease signs and symptoms, including chronic fatigue, aching joints,  and her loss of ability  to perform routine lab procedures like pipetting. The case describes Jamie's medical history, laboratory testing, initial diagnosis, preliminary treatment, and long term complications. To work through the case study students must define terminology, analyze data in the form or test results, and use critical thinking skills to apply the information. This case study is appropriate for any college level science or medically related course.

Objectives:
  • Define autoimmune disease, autoantibody, and discuss various autoimmune diseases and the role their specific autoantibody plays in the diagnosis.
  • Analyze a patient's history and identify medical and environmental triggers associated with autoimmune disease.
  • Describe the criteria used to diagnosis systemic lupus erythematosus, rheumatoid arthritis, Lyme disease, and mononucleosis.
  • Discuss several aspects of the nature of autoimmune diseases using systemic lupus erythematosus as an example.
  • Interpret and analyze blood tests, and understand how the results can be used to diagnose diseases such as systemic lupus erythematosus.
  • Explain how the newer drugs (Rituximab, etc.) differ from classic immunosuppressive drug therapy such as corticosteroids and the mechanism by which they suppress systemic lupus erythematosus.
  • Compare and contrast the advantages and disadvantages of the use of corticosteroids, or other drugs to treat systemic lupus erythematosus over a period of time.
  • Discuss the significance of myoglobin, cardiac troponin I, and creatine kinase isoenzymes in the diagnosis of acute myocardial injury.
Keywords: Lupus; systemic lupus erythematosus, Lyme disease; autoimmune diseases; rheumatoid arthritis; syphilis; mononucleosis
Topical Area: N/A
Educational Level: Undergraduate lower division, Undergraduate upper division, Professional (degree program), Clinical education
Formats: PDF
Type/Method: Directed, Interrupted
Language: English
Subject Headings: Biology (General)   Medicine (General)   Microbiology   Physiology  
Date Posted: 3/14/2014
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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