3. Chronic Inflammation Flashcards
Rheumatoid arthritis
a chronic, systemic inflammatory disorder that primarily affects joints.
It may result in deformed and painful joints, which can lead to loss of function. The disease may also have signs and symptoms in organs other than joints.
The cause of RA is not completely understood. The process involves inflammation and fibrosis of the capsule around the joints. It also affects the underlying bone and cartilage.
RA can produce diffuse inflammation in the lungs, the membrane around the heart, the membranes of the lung, and whites of the eye. It can also produce nodular lesions, most common within the skin.
(Osteoarthritis: Degeneration of joints / loss of cartilage)
Chronic gastritis
Inflammation of stomach lining
Chronic gastritis refers to a wide range of problems of the gastric tissues.
The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining.
In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis.
Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn’s disease, certain connective tissue disorders, and liver or kidney failure.
Complications: metaplasia, gastric ulcers
Ulcerative colitis
Form of inflammatory bowel disease
only affects the colon and rectum, leaving the rest of the gastrointestinal tract unscathed
surgical removal of the colon and rectum cures ulcerative colitis, which actually means the disease does not recur after surgery
an intermittent disease
Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission.
Crohn’s disease
Type of inflammatory bowel disease
transmural pattern of inflammation, meaning the inflammation may span the entire depth of the intestinal wall.
Ulceration is an outcome seen in highly active disease. There is usually an abrupt transition between unaffected tissue and the ulcer - a characteristic sign known as skip lesions.
Under a microscope, biopsies of the affected colon may show mucosal inflammation, characterized by focal infiltration of neutrophils, a type of inflammatory cell, into the epithelium.
These neutrophils, along with mononuclear cells, may infiltrate the crypts, leading to inflammation (crypititis) or abscess (crypt abscess).
Granulomas, aggregates of macrophage derivatives known as giant cells, are found in 50% of cases and are most specific for Crohn’s disease.
The granulomas of Crohn’s disease do not show “caseation”, a cheese-like appearance on microscopic examination characteristic of granulomas associated with infections, such as tuberculosis.
Biopsies may also show chronic mucosal damage, as evidenced by blunting of the intestinal villi, atypical branching of the crypts, and a change in the tissue type (metaplasia).
Leprosy
Chronic infection caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis.
Initially, infections are without symptoms and typically remain this way for 5 to as long as 20 years.
Symptoms that develop include granulomas of the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain and thus loss of parts of extremities due to repeated injuries. Weakness and poor eyesight may also be present.
Leprosy is spread between people. This is believed to occur through a cough or contact with fluid from the nose of an infected person.
Syphilis
a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. It may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis.
signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary). The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration), secondary syphilis with a diffuse rash which frequently involves the palms of the hands and soles of the feet, latent syphilis with little to no symptoms, and tertiary syphilis with gummas, neurological, or cardiac symptoms.
Sarcoidosis
disease involving abnormal collections of inflammatory cells (granulomas) that can form as nodules in multiple organs.
The granulomas are most often located in the lungs or its associated lymph nodes
Sarcoidosis seems to be caused by an immune reaction to an infection or some other trigger (called an antigen, which may be from one’s environment) that continues even after the initial infection or other antigen is cleared from the body.
In most cases it clears up by itself without any medical intervention, but some cases go on to affect the person long-term or become life-threatening and require medical intervention, most often with medications.
1 alpha, 25(OH)2 Vitamin D3 is the main cause for high blood calcium in sarcoidosis and is overproduced by sarcoid granulomata. Gamma-interferon produced by activated lymphocytes and macrophages plays a major role in the synthesis of 1 alpha, 25(OH)2 Vitamin D3.
Wegener’s granulomatosis
Granulomatosis with polyangiitis (GPA)
a systemic disorder that involves both granulomatosis and polyangiitis. It is a form of vasculitis (inflammation of blood vessels) that affects small- and medium-size vessels in many organs.
Damage to the lungs and kidneys can be fatal.
It requires long-term immunosuppression.
Granulomatosis with polyangiitis is part of a larger group of vasculitic syndromes called systemic vasculitides or necrotizing vasculopathies, all of which feature an autoimmune attack by an abnormal type of circulating antibody termed ANCAs (antineutrophil cytoplasmic antibodies) against small and medium-size blood vessels.
Tuberculosis
a widespread, and in many cases fatal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis.
typically attacks the lungs, but can also affect other parts of the body.
It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air.
Most infections do not have symptoms, known as latent tuberculosis. About one in ten latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected.
The classic symptoms of active TB infection are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss
Infection of other organs causes a wide range of symptoms.
Diagnosis of active TB relies on radiology (commonly chest X-rays), as well as microscopic examination and microbiological culture of body fluids. Diagnosis of latent TB relies on the tuberculin skin test (TST) and/or blood tests.
Treatment is difficult and requires administration of multiple antibiotics over a long period of time.
Prevention relies on screening programs and vaccination with the bacillus Calmette-Guérin vaccine.
