Posted: March 16th, 2022

Rheumatoid Arthritis is an autoimmune which typically affects women more than men in a 3:1 ratio

Rheumatoid Arthritis is an autoimmune which typically affects women more than men in a 3:1 ratio. The reason for this is not clear, however, it is stated that hormones and genetic x-linked factors play a role causing women to be more affected by the disease than men (Sokka et al., 2009). Also, men have a higher muscle mass opposed to women allowing them to better compensate for the functional loss which is suffered throughout the process. Because there is constant inflammation in the joints, (this disease affects synovial joints), there is loss in function which leads to deterioration of cartilage and bone (Van Vollenhoven, 2009).

Invasive Aspergollosis occurs in patients who are immunocompromised who are prescribed steroids for illnesses such as cancer who are undergoing chemotherapy, the lungs being the most commonly affected. They are found to be neutropenic with a weakened immune system. Aspergollosis genus name is A. fumigatis which is found in tropical climates (Rudramurthy et al., 2019). Some common signs and symptoms of Invasive Aspergollosis are cough, fever, and shortness of breath. Vascularly, a patient presents with chest pain and or hemoptysis resulting from pulmonary infaction (Sherif & Segal, 2010).

In this scenario, the patient’s occupation (closely related to an agricultural worker) as a grain inspector exposes him to fumigants which increase the symptoms associated with RA. Exposure to grain dust can cause what is known as “grain fever” which can manifest as chronic respiratory disease (productive cough, nasal and eye irritation, and wheezing). He is afebrile due to one of the clinical manifestation associated with Invasive Aspergollosis and his feeling fatigue. This patient suffers from Rheumatoid Arthritis and part of the treatment is Methotrexate and Prednisone which immunosupressive drugs causing his immune system to weaken and making him more suseptible to illness. The hemoptysis he has been experiencing is due to Invasive Aspergollosis due to pulmonary infarction as well as the chest pain, sweats and chills. These are all clinical manifestations associated with Invasive Aspergollosis.

According to Hohl (2017), “host defense against conidia and hyphae occurs via distinct molecular mechanisms that involve intracellular and extracellular killing pathways, as well as cooperation between different myeloid cell subsets. The strength and efficacy of the host response is shaped by the tissue microenvironment. In preclinical models of disease, host immune augmentation strategies have yielded benefits, yet translating these insights into therapeutic strategies in humans remains challenging”. Confirmation of the disease is done by CT imaging of the lungs as well as lab work.

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Rheumatoid Arthritis is an autoimmune disease that affects women three times more than males. The reason for this is unknown; however, hormones and genetic x-linked variables are thought to play a part in women being more impacted by the disease than men (Sokka et al., 2009). Furthermore, men have more muscular mass than women, allowing them to better compensate for the functional loss that occurs during the process. Because of the persistent inflammation in the joints (this disease affects synovial joints), there is a loss of function, which leads to cartilage and bone degradation (Van Vollenhoven, 2009).

Invasive Aspergollosis arises in immunocompromised patients who are being treated with steroids for conditions such as cancer.

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