Question

Case Study 1 Immunology.

Directions (3 page maximum).

I have identified the disease this man has is AIDS (Acquired immunodeficiency syndrome) now I need to;

2. describe what the outcomes of the disease or immunological problem is in the context of the immune system and where might there be deficiencies or problems with the normal immune system function.

3. Lastly, describe how the immune system would be working in a healthy individual. This could include a brief description of how the specific part of the immune system identified as being deficient normally works in a stepwise pathway that we cover in class. You can either use words to describe these pathways or you can draw pictures well annotated with high detail and include them as pictures with your word document you submit.

Martin Thomas is a 42 year old African American police officer who has always been in good health. He has been married for 10 years and has one child, an 8 year old daughter. 6 months ago he went to the emergency room at the local hospital complaining of fever and a swollen right hand. He was admitted to the hospital for the hand infection, which was assumed to be the result of a cat scratch. His blood lymphocyte count was very low. A blood sample was sent for testing to determine whether he had antibodies against HIV. Both ELISA and western blot revealed the presence of anti-HIV antibodies. He was referred to a doctor at Mass. General hospital.

Martin Thomas told the doctor that he had several homosexual encounters prior to being married 10 years ago. He had always been in good health until 6 months ago. He started to have drenching night sweats several times a week. Over this period his body weight dropped form 94.5 kg to 90 kgs. He could not remember having any infections other than the one in his hand nor any rashes, g.i. problems, cough, shortness of breath or any other symptoms. His mother had been 84 when she died of a heart attack and his father had died at 87 from cirrhosis of the liver, cause unknown. His wife and child were both in good health and his wife had recently tested negative for HIV. He did not smoke or use i.v. drugs. He drank large amounts of beer on weekends.   A cat and dog were the only household pets.

On physical examination his blood pressure was 130/90, pulse 92 and temperature 37.5C. Nothing abnormal was found during the exam. His white cell count was 5800/ul, his hematocrit was 31.3, and platelets werte 278,000/ul (all normal). However his CD4 T cell count was very low at 170/ul (normal 500-1500/ul). His HIV RNA load was 67,000 copies/ml.

He was prescribed trimethoprim sulfamethoxazole for prophylaxis against Pneumocystis jiovecii pneumonia. He was also given Highly active antiretroviral (HAART) therapy and counseled about safe sex with his wife.

After 5 weeks of therapy his HIV viral load declined to 400 RNA copies/ ml and after 8 weeks to <50 copies. In the meantime his CD4 counts recovered to 416/ul. He recovered from his infection and other symptoms resolved.

What had Martin Thomas developed and how was is causing issues with his immune system?

Answer 1

Martin Rhomas has infected with Human Immunodeficiency Virus which caused alot of issues in his immune system.

HIV attacks a specific type of immune system cell in the body. It’s known as the CD4 helper cell or T cell that are essential for maintaining our immunity.When HIV destroys this cell, it becomes harder for the body to fight off other infections.

When HIV is left untreated, even a minor infection such as a cold can be much more severe. This is because the body has difficulty responding to new infections.

Not only does HIV attack CD4 cells, it also uses the cells to make more of the virus. HIV destroys CD4 cells by using their replication machinery to create new copies of the virus. This ultimately causes the CD4 cells to swell and burst.

When the virus has destroyed a certain number of CD4 cells and the CD4 count drops below 200, a person will have progressed to AIDS.

However, it’s important to note that advancements in HIV treatment have made it possible for many people with HIV to live longer, healthier lives.