Autoimmune Flashcards
C-reactive protein Normal
0-10 mg/dL
C-reactive protein
an acute phase reactant its function is to respond to inflammation in the body. CRP test is not specific for one disease state, it just indicates inflammation. CRP-HS has a higher sensitivity, good for Cardiac issues
The higher the CRP, the higher their chance of a disease state that involves inflammation (mild can be post-exercize, severe can be from a severe trauma)
ANA
Antinuclear antibody
Important in the diagnosis of systemic lupus erythramatosus (SLE)
ANA tests the presence of antibodies towards proteins that are innate in the healthy person (DNA, RNA, etc)
Not just for lupis diagnosis- positive ANA tests also common in RA, Sjogrens, Progressive systemic sclerosis, etc.
SLE
The butterfly rash! fatigue weight loss myalgias Lymphadenopathy multiple organ involvement
scleroderma
Progressive systemic sclerosis
Skin thickening and hardening!
Autoimmune disease
Also manifest with fatigue and myalgias
because their fingers get super hard, they can get uclcers at their digits.
Sjögren Syndrome
Autoimmune disease that manifests with decreased lacrimal and salivary activty.
Dry eyes and dry mouth
RA
- Autoimmune disease that manifests with joint stiffness, pain, swelling and eventual deformity of MCP and PIP joints of hands
- Rheumatoid arthritis differs from osteoarthritis in that it is caused by autoantibody destruction of joint tissue and has systemic manifestations.
usually presents bilaterally and symmetricaly
Rheumatoid Factor
test used to determine if RA.
- Predominantly composed primarily of IgM antibodies directed against the portion of an IgG antibody known as the Fc fragment.
- 60-80% of individuals with rheumatoid arthritis have the rheumatoid factor and levels increase with higher levels of disease activity/severity.
RF is not specific to RA- can be elevated in cases of lupus, polymyositis, and also infections (TB, syphillis, influenza, mono, hepatitis).
Erythrocyte Sedementation Rate
ESR
It is an acute phase reactant. Commonly referred to as a “sed rate”
Non-specific test used as a marker for inflammation, infection, neoplasm and tissue necrosis or infarction. It cannot be used solely to diagnose a pathology. It is used to AID in diagnosis. False positives are common.
Test performed over 60 minutes, observe the “rate of fall”. Normal is 0-20mm/hr. If over 100mm/hr there is clearly an infection process.
Rouleux
stacking of RBCs
In an ESR test, RBCs are normally negatively charged, and repel each other. In states of inflammation, the body releases things like antibodies and fibrinogen, which increases the positive charge in the blood–> makes the blood more neutral–> allows the RBCs to stack onto each other.
ANA test
ANA antibodies identified via indirect immunofluorescence.
Blood sample diluted in serial dilutions, and the highest dilution at which the antinuclear antibodies are detected is reported as a result.
1: 40 dilutions and lower is a negative result (you lose the signal because there isn’t a lot of it)
1: 160 and up is a positive result
the result 1:320 means that one part blood sample was mixed with 320 parts of a diluting substance and ANA was still detectable.
Polymyositis/Dermatomyositis
Autoimmune disease that manifests with proximal skeletal muscle weakness, pulmonary disease, Dysphagia, polyarthritis and various dermatological manifestations.
Thyroid Tests
- Thyroid-stimulating hormone (TSH)–> the big kahuna.
- Thyroxine (T4)
- Free thyroxine (Free T4)
- Triiodothyronine (T3)
- Free triiodothyronine (Free T3)
Primary Hypothyroidism
•defect in thyroid gland itself
- Autoimmune thyroiditis (Hashimoto’s thyroiditis)
- Most common cause of hypothyroidism
- Caused by autoimmune destruction and apoptosis of thyroid cells by TSH stimulation blocking antibody (or TSBAb)
TSH levels are going to be increased, so greater than 5- the Anterior pituitary senses decrease in T3 and T4 and will bombard the system with TSH
Secondary Hypothyroidism
•decreased secretion of TSH from pituitary or decreased TRH from hypothalamus
Less common
Caused by a pituitary tumor, or post partum pituitary necrosis (body freaks out after mass acute blood loss)
