Autoimmune Disease Serology

Question 0

List at least 5 autoimmune diseases

Answer 0

SLE, rheumatoid arthritis, scleroderma, Sjogrens syndrome, polymyositis, thyroiditis, and cirrhosis

Question 1

This means resistant to self by having or producing antibodies or resistance

Answer 1

Autoimmune

Question 2

What is the cause of rheumatoid arthritis?

Answer 2

Cause UNKNOWN

Question 3

List, in order, the sequence of events that occurs to produce symptoms associated with rheumatoid arthritis

Answer 3

1 Production of abnormal IgG by synovial B lymphocytes 2 Production of 7S & 19S rheumatoid factors 3 Immune complex formation in synovium 4 activation of classical and alternate complement systems 5 initiation and amplification of inflammatory response 5 arthritis

Question 4

this is a condition in which immune cells that have the potential for reacting against self components are normally maintained in a state of unresponsiveness, otherwise known as self tolerance

Answer 4

autotolerance

Question 5

a heterogenous collection of antibodies that react with human or rabbit IgG and may react with IgG from different human individuals with different degrees of reactivity; they have the capacity to react with normal human IgG by precipitation or agglutination

Answer 5

rheumatoid factors

Question 6

What is the principle of the rheumatoid factor latex agglutination test?

Answer 6

Passive (hem)agglutination

Question 7

What is the test antigen in RF latex agglutination?

Answer 7

human IgG

Question 8

Which types of rheumatoid factors are detected in RF latex agglutination?

Answer 8

Primarily 19S IgM rheumatoid factor

Question 9

Describe a positive and negative rheumatoid factor result

Answer 9

positive = agglutination/negative = no agglutination

Question 10

Why are rheumatoid factor determinations inadequate presently to detect all rheumatoid factors?

Answer 10

1 no single test is both sensitive and specific
2 latex test detects primarily 19S IgM RF so it is possible to have a negative result in a person who has rheumatoid arthritis because it involves another type of RF

Question 11

Describe the Anti-cyclic citrullinated peptide (anti-CCP)

Answer 11

citrulline is incorporated into tissues during inflammation and antibodies form against the citrullinated structures (citrullinated peptides)

Question 12

What is an advantage to the anti-CCP test?

Answer 12

provides good sensitivity and better specificity for rheumatoid arthritis diagnosis than other assays used currently

Question 13

List the clinical symptoms of SLE

Answer 13

renal problems, butterfly rash on face, photosensitivity, and arthritis (highest incidence in young women of childbearing age)

Question 14

These are antibodies in the serum of SLE patients that bind to nuclear components: DNA, RNA, histones

Answer 14

antinuclear antibodies (ANA)

Question 15

What is the principle of the ANA test?

Answer 15

indirect immunofluorescence

Question 16

What is different about this indirect immunofluorescence method?

Answer 16

The antigen is Nucleated cells (HEp-2) fixed on the slide; this will allow us to also look at mitotic stages

Question 17

What antibodies are detected in the IFA procedure?

Answer 17

antinuclear antibodies

Question 18

What does a negative result look like in an ANA test?

Answer 18

No fluorescence, reddish color

Question 19

What does a positive homogeneous pattern in an ANA test look like?

Answer 19

smooth and evenly distributed, mitotic cells have a smooth bright green band in the center

Question 20

What does a speckled pattern look like in the ANA test?

Answer 20

You have to look at mitotic cells; the chromatin in these cells appears as a dark center

Question 21

What does a centromere pattern look like in an ANA test?

Answer 21

Thick countable dots seen; in mitotic cells chromatin fluoresces but is NOT smooth; appearance of zippers or beaded

Question 22

What does a peripheral rim pattern in the ANA test look like?

Answer 22

Brighter rim than the center of the cell, looks like a halo

Question 23

What does a nucleolar pattern look like in the ANA test?

Answer 23

Nucleoli inside the nucleus fluoresce

Question 24

Can a diagnosis be made from an ANA result?

Answer 24

No definitive diagnosis can be made based on an ANA result.

Question 25

The centromere pattern is thought to be a specific indicator of scleroderma with ______ syndrome

Answer 25

CREST

Question 26

What does CREST stand for?

Answer 26

C- calcinous
R- Raynaud's Disease
E-Esophagus dysfunction
S-sclerodactyly
T-telangiectasia

Question 27

What does cytoplasmic fluorescence signify in the ANA test?

Answer 27

Anti-smooth muscle antibodies (ASMA) and antimitochondrial antibodies (AMA) are “accidently” detected and may aid in differentiating liver disease