Auto-immune mini-symposium Flashcards
How are multi-system autoimmune diseases diagnosed?
Cardinal features (Hx, exam) Immunology Imaging Tissue Exclusion
What is the classification criteria for SLE?
4 of: Malar rash Discoid rash Photosensitivity Oral ulcers Arthritis (2 joints) Serositis Renal Neurological (seizures) Haematological features Immunological features Anti-nuclear antibody
What are the skin manifestations of SLE?
Discoid/Malar rash
What is the presentation of Scleroderma?
Morphea
Hard, thickened areas of skin in different areas of the body
Limited or diffuse
What are the complications of limited scleroderma?
Pulmonary hypertension
What are the complications of diffuse scleroderma?
Pulmonary fibrosis
Renal crisis
Small bowel bacterial overgrowth
How does Sjogren’s syndrome present?
Dry eyes
Dry mouth
Parotid gland enlargement
Systemic upset (fatigue, fever, myalgia, arthralgia)
What are the complications of Sjogren’s syndrome?
Lymphoma Neuropathy Purpura Interstitial lung disease Renal tubular acidosis
How does Auto-immune myositis present?
Symmetrical, diffuse, proximal Muscle weakness Polymyositis Dermatomyositis: - Gottron's papules - Heliotrope rash
What complications are associated with Auto-immune myositis?
Cancer
Interstitial lung disease
What are the large vessel vasculitidies?
Takayasu Arteritis
Giant Cell Arteritis
What are the medium vessel vasculitidies?
Polyarteritis Nodosa
Kawasaki disease
What are the small vessel vasculitidies?
ANCA-associated vasculitis
Immune Complex SVV
What are the diagnostic criteria for Giant Cell arteritis?
3 of: Age >50 New headache STA tenderness ESR >50 Abnormal temporal biopsy
What are the ANCA-associated vasculitidies
Granulomatosis with polyangiitis
Microscopic Polyangiitis
Eosiniphilic granulomatosis with polyangiitis
How does Granulomatosis with polyangiitis present?
Necrotising granulomatous inflammation (respiratory tract)
Nose bump
Necrotising glomerulonephritis
How does Microscopic Polyangiitis present?
Necrotising vasculitis
Necrotising glomerulonephritis
Pulmonary capillaritis
How does Eosiniphilic granulomatosis with polyangiitis present?
Respiratory tract inflammation with eosinophil-rich necrotising granulomatosis
Associated with asthma, eosinophilia
What is the use of renal biopsy of Lupus?
Classification of lupus nephritis
1-6
What is the treatment of multi-system autoimmune disease?
Hydroxychloroquinine Azathioprine Methotrexate Cyclophosphamide Rituximab
