A 65-Year-Old Obese African American Male Patient Presents

A 65 Year Old Obese African American Male Patient Presents To His Hcp

A 65-year-old African American male patient with obesity presents to his healthcare provider with crampy left lower quadrant pain, constipation, and fevers up to 101°F. His medical history includes recurrent episodes over the past 15 years that have responded to bowel rest and oral antibiotics. Despite recommendations, he refused colonoscopy initially, despite having risk factors such as a history of diverticulitis, a sedentary lifestyle, a diet low in fiber, and a family history of colon cancer from his paternal grandfather. Eventually, he underwent colonoscopy, which revealed multiple polyps diagnosed as adenocarcinoma.

Develop a 1- to 2-page case study analysis in which you: Explain why you think the patient presented the symptoms described. Identify the genes that may be associated with the development of the disease. Explain the process of immunosuppression and the effect it has on body systems.

Paper For Above instruction

The patient's presentation with crampy lower quadrant pain, constipation, and fever is characteristic of complicated diverticulitis or possible colon malignancy. His symptoms of pain and fever suggest ongoing inflammation or infection of the colon, likely due to diverticulitis, which is common in individuals with a low-fiber diet and sedentary lifestyles, as seen in this patient. The recurrent episodes over 15 years imply a chronic inflammatory process that predisposes to complications like perforation, abscess formation, or tumor development.

The eventual diagnosis of colon adenocarcinoma indicates the progression from chronic inflammation to malignant transformation, which is often linked to genetic mutations. In particular, genes such as APC (adenomatous polyposis coli), KRAS, TP53, and mismatch repair genes (MLH1, MSH2) are strongly associated with colorectal carcinogenesis (Barker et al., 2016). The APC gene mutations are characteristic of familial adenomatous polyposis (FAP) and also occur sporadically in colon cancers, initiating adenoma formation. Mutations in KRAS and TP53 promote tumor progression. Defects in mismatch repair genes lead to microsatellite instability, which is prevalent in hereditary non-polyposis colorectal cancer (HNPCC) or Lynch syndrome.

The patient's family history of colon cancer suggests a possible hereditary predisposition, particularly Lynch syndrome, which involves germline mutations of mismatch repair genes (Lynch et al., 2015). Genetic screening for these mutations can help identify at-risk individuals and inform surveillance strategies.

Regarding immunosuppression, it refers to the diminished efficacy of the immune system to detect and eliminate malignant cells or pathogens. Immunosuppressive states can be caused by genetic conditions, medications (e.g., post-transplant immunosuppressants), or systemic illnesses. These states impair various components of the immune response, including T-cell function, antibody production, and macrophage activity, leading to increased susceptibility to infections and malignancies (Khan & Kaur, 2019).

In the context of cancer, immunosuppression allows tumor cells to evade immune surveillance, thereby facilitating tumor growth and metastasis. For instance, reduced T-cell activity diminishes cytotoxic responses against tumor cells, and impaired antigen presentation can hinder immune recognition (Sharma & Kanneganti, 2020). Furthermore, systemic immunosuppression impacts other body systems by increasing vulnerability to opportunistic infections, affecting wound healing, and altering inflammatory responses, which can complicate disease course and treatment outcomes.

In summary, this patient's chronic inflammatory background, family history, and genetic predispositions contribute to his development of colorectal cancer. Understanding the genetic mutations involved aids in targeted screening and early detection. The role of immunosuppression emphasizes the importance of immune function in controlling tumor progression and protecting against infections, highlighting the need for tailored management strategies in immunocompromised patients.

References

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• Sharma, P., & Kanneganti, T. D. (2020). The impact of immune suppression on tumor development. Cancer Immunology Research, 8(4), 560–565.
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• Liu, X., et al. (2020). Role of mutations in immunoregulation of colorectal cancer. Frontiers in Immunology, 11, 615927.