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  • Lupus erythematosus

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  • 695.4 Lupus erythematosus
  • PT diagnoses/treatment diagnoses that may be associated with immune disorders affecting movement
    • 315.4 Developmental coordination disorder
    • 718.07 Articular cartilage disorder, ankle and foot
    • 718.03 Articular cartilage disorder, forearm
    • 718.04 Articular cartilage disorder, hand
    • 718.45 Contracture of joint, pelvic region and thigh
    • 719.39 Palindromic rheumatism involving multiple sites
    • 719.4 Pain in joint
    • 719.70 Difficulty in walking involving joint site unspecified
    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
    • 729.9 Other and unspecified disorders of soft tissue
    • 729.1 Myalgia and myositis, unspecified
    • 729.9 Other disorders of soft tissue
    • 736.9 Acquired deformity of limb site unspecified
    • 780.7 Malaise and fatigue
    • 781.2 Abnormality of gait
    • 782.3 Edema
    • 786.0 Dyspnea and respiratory abnormalities
    • 786.05 Shortness of breath

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  • L93.0 Discoid lupus erythematosus
  • L93.2 Other local lupus erythematosus

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Description

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  • A long term autoimmune disease that attacks the body’s tissues and organ systems as if they were foreign substances
  • Affects skin, joints, kidneys, brain, and other organs
  • Although SLE is most common form, there are others: discoid or cutaneous lupus, drug-induced systemic lupus, neonatal lupus, and subacute cutaneous lupus
  • Onset often vague with misdiagnosis

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Essentials of Diagnosis

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  • Must be made by a physician and confirmed by medical diagnostic testing
  • According to the American College of Rheumatology (ACR)2 4 of 11 of the following must be present:
    • Malar rash: a rash over the cheeks and nose, often in the shape of a butterfly
    • Discoid rash: a rash that appears as red, raised, disk-shaped patches
    • Photosensitivity: a reaction to sun or light that causes a skin rash to appear or get worse
    • Oral ulcers: sores appearing in the mouth
    • Arthritis: joint pain and swelling of two or more joints in which the bones around the joints do not become destroyed
    • Serositis: inflammation of the lining around the lungs (pleuritis) or inflammation of the lining around the heart that causes chest pain, which is worse with deep breathing (pericarditis)
    • Kidney disorder: persistent protein or cellular casts in the urine
    • Neurological disorder: seizures or psychosis
    • Blood disorder: anemia (low red blood cell count), leukopenia (low white blood cell count), lymphopenia (low level of specific white blood cells), or thrombocytopenia (low platelet count)
    • Immunologic disorder: abnormal anti-double-stranded DNA or anti-Sm, positive antiphospholipid antibodies
    • Abnormal antinuclear antibody (ANA)

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • May result in secondary problems
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems
    • Weight loss indicating the need for physical therapy
  • Because lupus and other immune disorders frequently refer pain or are ...

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