Autoimmune disorders are those that occur as a result of a hypersensitive immune system. The immune system attacks and destroys healthy body tissue. Typically autoimmune disorders affect the working of RBC, endocrine glands such as thyroid, muscles and joints. Examples of autoimmune disorders include Type I diabetes, Rheumatoid arthritis, pernicious anemia, Grave's disease and Multiple sclerosis.
Pruritus is a skin disease associated with conditions pertaining to autoimmune disorders and other advanced complications like liver cirrhosis. Pruritus cases vary from mild to complex as the symptoms associated with the condition generally aggravate with age. Untreated pruritus can be a big hindrance to an individual's normal life as it interferes with sleep patterns leading to irritability and stress. In some cases the causative agent for this disease is the Hepatitis C virus which accounts in 20% of the population.
Pruritus occurs mostly in the wrist and ankles as a scratch. The intensity of the itch facilitates other factors such as eczema, impetigo and induced urticaria. The immune response releases histamines causing allergic reactions. The association of pruritus with allergic reactions is identified by the presence of serotonin. The serotonin release caused because of pruritus occurs in case of preexisting medical conditions such as polycythemia, lymphoma and cholestasis.
The identification and diagnosis of pruritus is closely associated with the evaluation of dermatological condition of the patient. Progressive pruritus is noticed with contact dermatitis, urticaria, scabies, pediculous infections of the genital region, folliculitis and xerotic eczema.The factors associated with the respective causes along with pruritus are fomites, dust, bites, chemicals and photosensitivity. Atopic dermatitis induces aggressive form of pruritus. The intense forms of atopic dermatitis associated pruritus usually occur in pregnant women, infants and veterans. Systemic causes of pruritus involve preexisting conditions such as Hodgkin's lymphoma, HIV, scleroderma, multiple myeloma, chronic renal failure and many other conditions.
Pruritus diagnosis involves meticulous procedures in examining the exact history of the patient to rule out other forms of allergic reactions. The information pertaining to the patient history includes several factors such as travel zones, food and occupation. Differentiation of non-septic and septic forms is done to identify systemic involvement of the disease. Secondary infections and malignancies associated have to be identified. Specific sites are identified on the skin reaction to respective drug therapy is carefully monitored.
Avoid stress which delays the healing process. Topical creams are prescribed for allergic forms of pruritus. Skin cleansing is an important step. It is predominantly done to prevent secondary infections and conditions such as psoriasis. Patients who have history of sunburn and sensitivity to extreme temperatures need to relieve the stress upon immune system that reacts immediately to such conditions. Hydration of the skin helps in the restoration of the skin cells to facilitate the process of healing. Change of diet and lifestyle is prescribed to patients who are sensitive foods such as nuts, seafood etc. Patients with a history of contact dermatitis are advised to use skin safe deodorants, shampoos and bubble bath solutions. Oral antihistamines are recommended to ease the immune system's reactivity. Hot water bath and tight clothing are to be avoided in case of pruritus as it may aggravate the condition. Topical creams containing corticosteroids are recommended during the onset of a pruritic reaction. In case of secondary infections associated with pruritus, antibiotics are given.
Luteinizing Hormone LH is another important hormone for reproduction. In men, LH promotes secretion of testosterone. In women, LH surge in the second part of the menstrual cycle triggers ovulation. LH is released when a woman is ovulating, and causes the ovaries to release an egg. LH and FSH are closely linked. At the beginning of the menstrual cycle, FSH and LH are secreted to stimulate ovarian follicles. Mid-cycle, the growing follicle will inhibit FSH secretion and increase estrogen. This is a trigger for sudden release of LH that leads to release of the mature egg.
The LH Surge is vital for pregnancy - as it causes the matured egg to be released. The next 24 - 36 hours are the fertile window when a woman can get pregnant. Ovulation Predictor Kits that are available measure LH level in the urine - identifying the best time to conceive. Reduced levels of LH in females indicate ovarian hyperfunction.
LH and PCOS
In females suffering from PCOS - Polycystic Ovarian Syndrome, the LH levels are already elevated when compared to FSH. Since there is no LH surge, ovulation does not take place. Elevated LH levels cause release of androgens from the ovaries leading to acne and Hirsutism. Infertility and miscarriage are common. Studies have shown that there is a direct relation between insulin resistance and elevated LH levels.
In females, the LH levels in the blood can vary based on stage of menstrual cycle, age, pregnancy and other pituitary gland disorders. It can be measured by a blood test or urine test. Usually this test is prescribed for women with irregular periods trying to get pregnant or assessing if a woman has entered menopause. Men with low testosterone levels or having very late puberty are asked to take the LH test.
High levels of Luteinizing hormone are most often caused by ovarian tumors or improperly-developed ovaries. Thyroid or Adrenal disease can elevate LH levels. PCOS and Autoimmune disorders also cause the levels of Luteinizing hormone to rise. Low levels of Luteinizing hormone indicate ovarian failure or primary testicular failure. This can happen due to viral infections such as mumps, autoimmune disorders, radiation exposure and tumors.
Early phase of menstrual cycle: 0.5 to 16.9 IU/L
Peak of menstrual cycle: 8.7 to 76.3 IU/L
Using contraceptives: 0.7 to 5.6 IU/L
Pregnant: less than 1.5 IU/L
Menopause: 15.9 to 54.0 IU/L
Between 20 years and 70 years: 0.7 to 7.9 IU/L
Over 70 years: 3.1 to 34.0 IU/L
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Bibliography / Reference
Collection of Pages - Last revised Date: June 17, 2019