In this case study below, we will be covering more in-depth information regarding the patient's previous condition, recent symptoms, and new diagnosis. The genes are associated with the development of both diseases, and the immunosuppressive process

Case Study Analysis (Scenario 1) A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever. The patient's current medications include atorvastatin 40 mg at night, methotrexate 10 mg PO every Friday morning, and Prednisone 5 mg PO QAM. He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats. He says he has had more fatigue than usual and reports chest pain associated with coughing. He admits to having occasional episodes of hemoptysis. He works as a grain inspector at a large farm cooperative. After extensive workup, the patient was diagnosed with Invasive Aspergillosis. Explanation of clinical manifestation for patient symptoms The patient's primary symptoms include fever up to 101 degrees, fatigue, chills, sweats, chest pain associated with coughing, and episodes of hemoptysis. The best way to understand why the patient presents the symptoms described is by analyzing in-depth their previous condition and his new diagnosis. The first step when examining the patient is that he has a weak immune system due to immunosuppression therapy to treat RA and the disease itself. He got infected with an opportunistic fungal Aspergillosis infection when working on a farm. Rheumatoid arthritis (RA): is a degenerative and progressive condition described as an autoimmune and inflammatory disease, with an estimated incidence of approximately 41/100,000 per year, characterized by chronic inflammation of the synovial joints, progressive bone erosion, and joint destruction, which cause progressive damage to the bone and cartilage of the joints, affecting his quality of life. That means that your immune system attacks the healthy cells in your body by mistake, causing damage to the bone and inflammation of the cartilage of the joint tissue in the affected parts of the body. (Panagopoulos, P. K., & Lambrou, G. I., 2018). This study source was downloaded by from CourseH on :26:04 GMT -06:00 4 Invasive Aspergillosis is a severe pulmonary fungal infection with a high mortality rate. These fungus spores are commonly found in the soil, plants, grains, indoors and outdoors environment, which are easily inhaled, through the respiratory system invading the mucosa, and grow in the lungs' alveoli. This fungus obstructs the airway, which leads to present symptoms of respiratory distress, dry cough, fever, chest pain, and occasional episodes of hemoptysis, like the symptoms the patient presents. It usually affects more people with immunosuppress systems or prolonged high-dose corticosteroid therapy like the patients use to treat the RA. (Naaraayan, A. et al., 2015). Genes associated to development of the disease RA causes the body to create autoantibodies to attack the healthy cells. Immune cell involvement in the disease is a good development. It is well recognized, as is the contribution of other types of cells in synovial tissue, like fibroblasts, and significant genetic associations with the HLA locus and non-HLA genetic variants. Rheumatoid factor (RF) and anti-citrullinated peptide/protein antibodies (ACPA, usually measured by anti-CCP ELISA) are most detected. (Padyukov L., 2022). RA is a prototype autoimmune disease, and the most relevant non-HLA gene single nucleotide polymorphisms (SNPs) associated with RA include PTPN22, IL23R, TRAF1, CTLA4, IRF5, STAT4, CCR6, PADI4. (Kurkó, J., Besenyei, T., Laki, J., Glant, T. T., Mikecz, K., & Szekanecz, Z., 2013). The inborn deficiency of (NADPH) and oxidase leading to CGD, is the example of primary immunodeficiency with a predisposition to Invasive Aspergillosis. As a result of the impaired production in the body of reactive oxygen, patients with CGD create pattern recognition receptors such as Toll-like receptors (TLRs) and the C-type lectin receptors (CLRs) to lead critical components of the innate immune system. TLR4 polymorphisms have been linked This study source was downloaded by from CourseH on :26:04 GMT -06:00