A 41-year-old woman with systemic lupus erythematosus has taken high-dose prednisone for 6 months. She presents with proximal muscle weakness, easy bruising, and recurrent oral candidiasis. Vital signs show BP 158/92 mmHg, HR 88, RR 16, temp 37°C. Labs reveal fasting glucose 186 mg/dL and 24-hour urine cortisol elevated. Skin striae are noted. She denies fever or weight loss. Which mechanism best explains prednisone's anti-inflammatory therapeutic action?
- A)Suppression of calcineurin mediated IL-2 transcription only in T cells
- B)Direct blockade of cyclooxygenase by irreversible acetylation
- C)Competitive antagonism of leukotriene receptors only
- D)Inhibition of phospholipase A2 via increased lipocortin expressionGABARITO
- E)Inhibition of folate synthesis in activated lymphocytes
Explicação
Glucocorticoids induce lipocortin, which inhibits phospholipase A2 and thereby decreases formation of arachidonic acid derived prostaglandins and leukotrienes. They also reduce cytokine production and impair leukocyte function, explaining both therapeutic bene... Ver explicação completa e trilha adaptativa →