Autoimmunity
Clinical Laboratory Science Mmbio 423 with Zundel at Brigham Young University
About this deck
By: Jason Thomas
Textbook:
Clinical Laboratory Chemistry
Created: 2011-10-20
Size: 48 flashcards
Views: 1
Textbook:
Clinical Laboratory ChemistryCreated: 2011-10-20
Size: 48 flashcards
Views: 1
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What is an autoimmune process?
Immune recognition and reaction against the individual’s own cells
What are some of the body's mechanisms of distinguishing between self and non-self?
- MHC antigen presentation
- Clonal deletions
- Antigen sequestering
- Interactions of all immune cells
- Effector molecules and cytokines
What four factors contribute to autoimmunity?
- Molecular mimicry
- Environmental conditions
- Genetic predisposition
- Hormonal influences
How does molecular mimicry contribute to autoimmunity?
Many viral and bacterial antigens are so similar to self antigens that an attack on the pathogen can result in an attack on self antigens.
What does SLE stand for?
System
What type of autoimmune disease is SLE?
Chronic systemic inflammatory disease
What systems are affected by SLE and how?
Kidney, skin, joints and choroid plexus in particular by deposits of complement fixing complexes of antibody with DNA, etc.
What is SLE caused by?
Unknown: possibly genetic, hormonal, environmental, or drug-induced
What are some general signs and symptoms of SLE?
- Chronic inflammation
- Arthritis
- Swollen lymph nodes
- Susceptible to opportunistic infections
Why is SLE so difficult to diagnose?
It is a highly variable disease presenting differently from person to person as well as from time to time.
What are SLE symptoms when the kidneys are involved?
Acute or chronic glomerulonephritis
What are SLE symptoms of pregnancy?
Increased incidence of premature delivery and spontaneous abortion
What are SLE symptoms when the heart is involved?
- Pericarditis
- Tachycardia
- Ventricular enlargement
What are SLE symptoms when the skin is involved?
Photosensitive rash (especially on cheeks and across bridge of nose - butterfly pattern)
How does the Indirect Fluorescent Antibody test work?
- Prepared cells are fixed to a slide
- Patient serum added - reacts with prepared cells
- Fluorescent-labeled anti-immunoglobulins are added
- Pattern is read
If performing an IFA titer, explain the significance of the results:
- < 1:20 is negative
- 1:40 - 1:160 suggests presence of ANAs
- > 1:160 is highly suggestive
What does ESR indicate? What does the ESR pattern look like in SLE?
Inflammation. Increased.
Which antibodies are present in a homogenous diffuse pattern ANA?
- Anti-DNA-histone
- Anti-DNP
What disease(s) does this homogenous diffuse pattern ANA suggest?
- SLE
- RA
Which antibodies are present in a peripheral rim pattern ANA?
anti-DNA
anti-dsDNA
anti-nDNA
anti-dsDNA
anti-nDNA
What disease(s) does this peripheral rim pattern suggest?
SLE
Which antibodies are present in a speckled pattern ANA?
- anti-RNP
- anti-Sm
What disease(s) does this speckled pattern suggest?
- RA
- SLE (if only anti-Sm detected, then only SLE possible)
- Liver disease
- MCTD
- Scleroderma
- Sjogren's syndrome
- Polymyositis
Which antibodies are present in a nucleolar pattern ANA?
anti-nucleolar-RNA
What disease(s) does this nucleolar pattern suggest?
Scleroderma
Sjogren's syndrome
Sjogren's syndrome
How is lupus treated?
Corticosteroids
What is an immune function of estrogen?
Enhances immune responses
What is the mechanism of rheumatoid arthritis?
IgM antibodies activate complement and direct it against the FC portion of IgG.
Why is anti-Sm antigen not the best for diagnosing SLE if it is so specific for SLE?
It is only positive in about 30% of SLE patients
What type of autoimmune disorder is Sjogren's Syndrome?
Chronic systemic inflammatory disorder
What is the mechanism of Sjogren's Syndrome?
Antibodies form against mucus secreting glands (salivary, tear ducts, etc.)
What is scleroderma?
A hardening of the skin
Why is scleroderma so bad?
It progresses to systemic sclerosis and collagen deposition plugs up many of the organs.
What is polymyositis and what are some of its symptoms?
An inflammatory muscle disorder characterized by muscle weakness, gradual onset, trouble speaking, swallowing, fatigue
What triggers polymyositis?
Possibly a bacterial or viral pathogen
What is Mixed Connective Tissue Disease (MCTD)?
It has overlapping symptoms of SLE, scleroderma, and polymyositis making it hard to distinguish from those.
What can suggest MCTD as opposed to SLE?
A high titer of speckled pattern is very suggestive of MCTD
Why must MCTD be monitored closely?
It can develop into full blown SLE
Is RA more common in women or men?
Women
What does RA do to life expectancy?
- Men usually die 4 years earlier than usual
- Women die 10 years earlier than normal
What are some symptoms of RA?
Malaise, fever, joint pain, weight loss, muscle spasm, deformity, nodules over bones
How do the symptoms progress in RA?
- Generalized symptoms
- Small joints to large joints
- Joint pain leads to muscle spasm
- Joint deformity
- Nodules over bones
What is rheumatoid factor?
- The IgM antibody that causes problems in RA
- It is not specific for RA however
What are the six criteria used for diagnosing RA?
- Morning Stiffness
- Arthritis of 3 or more joint areas
- Arthritis of hand joints
- Symmetric arthritis
- Serum rheumatoid factor
- Radiographic changes
How can they test for RA?
- Indirect agglutination (latex or rose-waaler hemagglutination)
- ELISA
- Nephelometry
- Anti-CCP (anticyclic citrullinated peptide)
What are some key lab results for RA?
- Decreased C3 and C4
- Positive RF
- Positive ANA (only in 20% of patients)
How is RA treated?
Mostly pallative (treat only symptoms): aspirin, NSAIDS, TNF blocker
About this deck
By: Jason Thomas
Textbook: Clinical Laboratory Chemistry
Created: 2011-10-20
Size: 48 flashcards
Views: 1
Textbook:
Clinical Laboratory ChemistryCreated: 2011-10-20
Size: 48 flashcards
Views: 1
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“I have used this website for three exams, and I see a huge difference in my test results.”
Naj
Naj