Autoimmune (Compare and Contrast) Flashcards
What is a type II autoimmune disorder?
- What type II autoimmune disorders are involve dysmorphic aspects of the skin?
- pathogenesis of these disorders?
*Type II immune disorders involving IgGs that are directed against surface determinants of your own cells
Diseases:
Scleroderma
- Anti-Centromere Abs. (CREST-type), Anti-Topoisomerase (Diffuse-type), Anti-Nuclear abs.
Pemphigus Vulgaris
- Abs. Specific for Desmoglein 1 and 3
What T cell mediated autoimmune disorder is treated with IFN-ß?
- what B cell mediated disorder has features comparable to this disorder and how does it come about?
- What B cell mediated disorder has a clinical presentation that is the inverse of this disorder?
Multiple Sclerosis
- TH1 vs. Myelin Sheath
- TH1 activates macrophages leading to Tissue distruction
- Food –> Head Progression
Gullian Barre Syndrome
- IgG is directed against Ganglioside = Demyelination
- Campylobacter Jejuni instigates this disorder through cross reactivity
- Foot –> Head Progression
Miller-Fisher Syndrome
- Head –> Foot Progression
What T cell mediated autoimmune diseases involve the destruction of glands?
- What are the specific causes of each of these diseases?
- Diagnostic Features?
Insulin-Dependent Diabetes Mellitus (IDDM)
- CTLs directed against ß-cells in the pancreas
- Dx. with Anti-Glutamate Dehydrogenase, Anti-insulin, or Anti-glutamate decarboxylase Abs.
Sjogrens Symdrome
- Autoreactive T cells for Salivary, Lacrimal, Vaginal Glands
- Dx. with Anti-SSRA/RO or Anti-SSB/LA Abs.
Hashimotos Thyroiditis
- CTL mediated killing of Thryoid
- Dx. antithyroglobulin, anti-TPO (thyroid peroxidase), anti-Microsomal Abs.
Differentiate between Autoimmune Hemolytic Anemia and Pernicious Anemia with respect to:
- Type of autoimmune disease
- Root cause of Anemia
- Effectivity of Coombs Test
Autoimmune Hemolytic Anemia
- Type II autoimmune Disease because IgG binds to the surface of the RBC
- RBCs are attacked by MAC and/or Phagocytosed
- POSITIVE Coombs test with this disease
Pernicious Anemia
- IgG binds to Intrinsic Factor preventing B12 absorption
- RBCs cant be produced without B12 (not destruction, lack of production)
- NEGATIVE Coombs test for these patients
What are some histological characteristics that define Pernicious Anemia?
- RBCs that are bigger than Lymphocytes
- Hypersegments Neutrophil Nuclei
What disorder involves the production of IgG against RhD factor?
Erythroblastosis Fetalis
In what disease might you expect to see TH1 CD4+ cells enriched in the CSF or Oligoclonal Bands of IgG in the CSF?
Multiple Sclerosis
What is the cause of APS (antiphospholipid syndrome)?
- what other autoimmune syndrome has APS as a side affect?
- A test for what unrelated condition will turn up as a false positive in these patients?
APS
- Anti-Cardiolipin and ß2-glycoprotein Abs. are made
- Immune complex deposition causes Vasculitis
Systemic Lupus Erythematosus - APS is an aspect of this condition
SYPHILLIS Test will come up positive in these individuals
Rheumatoid factor binds to what part of Abs?
- what condition is caused by different abs. that bind to the same place?
- ^ this disorder is often secondary to what?
Rheumatoid Factor binds Fc Region of Abs
CRYOGLOBULINS also bind the Fc Regions of Abs.
- this causes a Type III disorder via the many immune complexes generated
Mixed Essential Cryoglobulinemia is often secondary to a Lymphoproliferative disorder like Myeloma or Waldenstrom Macroglobulinemia
What are the fundamental differences in Autoimmune Myocarditis and Subacute Bacterial Endocarditis?
Autoimmune Myocarditis
- CTL mediated response to Myosin Heavy Chains in the Heart
- TH1 cells mediate Inflammation
(type IV response)
Subacute Bacteial Endocarditis
- IgG mediated inflammation (via Phagocytes ) after Strep Viridans Colonized damaged heart valves
What are some symptoms of the autoimmune disease that causes Microangioplastic Hemolytic Anemia?
- Disease cause
- Disease Treatment
Disease:
Autoimmune Thrombocytopenia Purpura
Cause:
- Defective vWF cleaving enzyme or
- Defective GpIIb/IIIa (dont know how)
Symptoms:
- Purpura
- Neurological Symptoms
- Kidney and Liver damage
What disease would you suspect if you had a patient whose symptoms began with Rhinitis and progressed until she had coin lesions in her lungs?
- What is the cause of this disease?
- What is the treatment of this disease?
Wegners Granulmatosis (aka Granulomatosis with Polyangiitis)
cause:
- PR3-ANCA and cANCAs (anti-neutrophil cytoplasmic bodies)
Treatment:
- Plasmaphoresis
- Anti-inflammatories
What causes neutropenia?
- what is the treatment?
IgG specific to surface determinants of Neutrophils (type II condition)
*Splenectomy is used because the principle cause of neutropenia is phagocytosis of neutrophils marked by abs.
In what autoimmune disease does smoking cause sufferers to have bloody infiltrates in their lung?
- what causes this disease?
- how is this disease diagnosed?
Goodpastures Sydrome
- Autoantibodies for Type IV collagen causes this disease
- Dx can be made using immunofluorescence to view abs. stuck on the glomerulus
What disease is sometimes brought on by a hepatitis B infection?
- Cause of the disease?
- major ailment?
- Clinical Features?
PAN (polyarteritis Nodosa)
- In the case of Hep B manifested disease HBsAg-HBsAb complexes cause vasculitis in MUSCULAR ARTERIES - this causes myalgia and artheralgia
- Patients often have Red Splotchy legs
