CASE REPORT

I. Patient profile and complaints

Mr. TC a 32-year-old African American living in a small town in the rural area suddenly experiencing
severe joint pains, shortness breath while working at the local grocery store. Prior to these symptoms, he
reported having difficulty climbing from 1 floor to another due to intermittent joints pains and severe
exhaustion. He noted generalized scattered skin rashes, easy bruising, generalized swelling, fatigue,
palpitations and headaches. He denies any episode of chest pain or dizziness. His symptoms gradually
resolved.

II. Patients' personal history and condition

Mr. TC reported that he was healthy growing up. He was physically active. No history of hospitalizations.
He was updated on all his immunizations as a child. He drinks alcohol occasionally, smokes 1-2 cigars
per day, and has no history of illicit drug use. No past medical history. Back in his childhood and teenage
days, he was known to be very athletic and energetic, not showing any signs of early fatigue or
exhaustion. He was not prone to any type of disease and was shown to have a very strong immune
system. Due to having played other sports and activities, he had a very good blood flow as well. His body
was very strong and healthy, when suddenly at the age of 24 he started working multiple jobs and the
stress was slowly getting into him. He started to notice few changes in his body and was not as energetic
as he once was. His body couldn’t handle long hours of working and gets tired easily even though he is at
the peak of his life. By the age of 26, the rashes started to appear on his body and his joints started to ache
when he overworks even if it’s only for a short amount of time. As he gets older, his joints began to ache
even more and is swelling sometimes, due to this, he got easily irritated and stressed causing him to get
headaches from time to time. His Father aged at 70 years old alive with hypertension and arthritis. Mother
passed away at age of 65 years old from unknown cause. He has 2 siblings ages 28 and 25 both healthy.
He went to his Primary Care Provider (PCP) as his symptoms are unbearable accompanied by new
intolerance to low temperatures, extremities becoming more painful, stiff and altered color when exposed
to cold temperatures and facial rashes. He was given Rx for Celebrex 200mg 1 tab twice a day (NSAID)
and was referred to Rheumatologist.

III. Patients’ Activity of daily life and Patient's Genetic Predisposition

The patient Mr. T C is an energetic and athletic person when he was in his teenage years, giving him many activities to do
every day. In the patient teenage years Mr. T C hobby is outdoor sports like going for a basketball after school to the
nearby basketball court in his school and biking every weekend afternoon with his friend (Sunlight exposure may bring on
lupus skin lesions or trigger internal response in susceptible people). The patient always does outdoors activity to fight the
stress given by his school works. These daily activity of the patient in his teenage years continues until he reaches
adulthood. in the patient adulthood he stops his sports activities because of work. Mr. T C having multiple jobs making his
schedule full and his works be his daily activities. The patient works at a local grocery in their area and working part time
jobs with different environment after working 8hrs in the grocery (working on different environments increase the chance
to encounter infection that can trigger lupus). During weekends the patient still works on Saturday with his part time job
and in Sunday he only stays at his house to rest. these daily activities in his adulthood are where his complaints started to
show. In the family background of the patient show that they don't have many histories of diseases. Some of the patient
family diseases cannot be genetically transmitted but his family has history in lupus (It's likely that lupus results from a
combination of your genetics and your environment), his grandmother on his mother side have lupus. Lupus having no
cure Mr. T C family do a treatment for his grandmother to help improve her symptoms, prevent flares, and prevent other
health problems that is often caused by lupus.