Antibodies Flashcards
Coeliac
anti ttg
anti endomysial
Sjorgens - Abs + associations + other tests
- xeropthalmia / xerostoma / anhidriasis / parotitis
look for scars beneath chin DIFFS = sarcoid parotid cancer mumps
primary rare
usually secondary where another AI disease present (RA or SLE)
anti Ro
anti La
RF present in 90%
Shirmer test:
lacrimation - litmus hung from eyelids = 5 mins >15mm water movement.
also:
RF - 90% (70% RA)
Ds DNA
assoc:
Primary 40x risk lymphoma
Primary sclerosing cholangitis
Bile duct and sinusoidal inflammation leading to progressive fibrosis and biliary obstruction
P-ANCA
ANA
and Anti-smooth muscle
ASSOC IBD
esp UC
SLE
anti-ANA +VE 95% - specific
anti ds-DNA - disease activity
low c3 and low c4 (heavy depostion in lupus nephritis)
- good marker for activity as well
Associations: anti-phospholipid anti-Sm = SMITH not SMOOTH MUSCLE ENA Ro La
PsA
Seronegative arthritis!
5 Patterns
1. RA like - symmetrical small joint - HLA DR4
2- Spondyloarthropathy (asymmetrical HLA B27)
3-DIPJ - HLA b38/b39
4- Arthritis mutilans - telescoping / dacytilitis /
5-oligoarthritis - asymmetry + massive effusions
Limited cutaneous systemic sclerosis
ANA = 90% anti-centromere = 80%
sclerodactyly
morphoea - tight shiny skin plaques
en coup de sabre over scalp
Sarcoid
None specific
Pathogenesis is related to a breakdown of normal immunofunction resulting in inappropriate propogation of a th2 response and intiiation of a granulomatous forming process
Some Abs are found directed against mycobacteria
hatpen reaction process
SCLC
Anti-YO + Anti-Purkinje = CEREBELLAR DEGENERATION
Anti-Hu - ENCEPHALOMYOSITIS
Myasethenia
Abs vs post synaptic NMJ ACH-R
lambert eaton
Abs Vs presynaptic voltage gated calcium channels
anti phospholipid
anti-phospholipid
ANA
Raynauds
Form of scleroderma
expect to see:
ANA
anti-centromere
LOOK FOR ADDITIONAL FEATURES TO IDENTIFY IF CREST PRESENT
look for ungal abscess - sign of dermatomyositis
look for pyoderma gangrenosum - dermatomyositis
look for where inolvement rests - thickened and hardedn skin from chronic ischaemia
look for signs of digital ulceration from chronic ischaemic damage
CREST-
dysphagia . diarrhoea, dyspepsia, dyspnoea + renal crisis
ANA = 90% anti-centromere = 80%
Remember greatest cause of morbidity is progression of pulmonary fibrosis and pulmonary hypertension by CREST and drugs used to treat
NSIP - surivival 12-14 years with good response to steroids
AIP - surivival 2.5-5 years with poor steroid response
i.e.
MTX and MMF for skin thickening
cyclophosphamide useful for pulmonary stabilisation and better survival
Calcinosis Raynauds Esophagial and GIT dysmotility Sclerodcatyly Telangiectasia
Diffuse cutaenous systemic sclerosis
greater incidence of pulmonary fibrosis
greater incidence if renal crisis
ANA 90%
anti SCL = 40%
Crohns
Anti-Saccharomyces cerevisiae antibodies (ASCA) are associated with Crohn disease;
anti-CBir, an antibody against flagellin, also is associated with Crohn disease (but not UC) and is found in about 40%
Associated with PSC - UC stronger association
- P-ANCA
- ANA
- anti-smooth muscle
