Autoimmune diseases Flashcards
what is the prevalence of SLE?
females: males 9:1
onset 15-15yrs (disease of the young)
afro carribeans>asian>caucasian
what are some of the presentations of SLE?
face: - butterfly rash - photosensitivity - allopecia nervous: - seizures - hemiplegia - ataxia - neuropathy - cranial nerve palsies chest: - pleurisy - pleural effusion - fibrosis skin: - vasculitis - purpura - urticaria heart: - pericarditis - endocarditis - arctic valve lesions blood: - anaemia - leukopenia - thrombocytopenia myopathy abdominal pain reynauld's phenomenon fever depression
what is the classification criteria for SLE?
any 4 of the following:
malar rash discoid rash photosensitivity oral ulcers arthritis serositis renal neurological haematological immunological ANA
what is the classifications of scleroderma?
limited (localised)
diffuse (systemic)
what is the prevalence of scleroderma?
onset 30-50yrs
female:male 3:1
what are the features of limited scleroderma?
also known as crest syndrome Calcinosis Reynaulds Esophageal dysmotility Sclerodactyly Telangiectasia
what are the complications of diffuse and localised scleroderma?
limited:
- pulmonary hypertension
diffuse:
- pulmonary fibrosis
- renal crisis
- small bowel overgrowth
what is the prevalance of sjogren’s syndrome?
onset 40-50s
female: male 9:1
what is sjogrens syndrome and how does it present?
an autoimmune connective tissue condition
presentation;
- dry mouth and eyes
- parotid duct enlargement
- malaise, fatigue, fever
- arthralgia, myalgia
what are the complications of sjogrens syndrome?
lymphoma neuropathy purpura interstitial lung disease renal tubular acidosis
what is autoimmune myositis?
a group of autoimmune conditions which cause inflammation and weakness in the muscles (polymyositis) or the skin and muscles (dermatomyositis)
what are the main presenting features of autoimmune myositis?
muscle weakness
raised CK
(no pain or stiffness)
what are the complications of autoimmune myositis?
cancer
interstitial lung disease
what are clinical signs associated with dermatomyositis?
gottron’s papules
heliotrope rash
what is the classification criteria for giant cell arteritis?
3 of the following: age > 50 yrs new onset headache temporal artery tenderness/reduced pulsation ESR > 50 abnormal temporal biopsy
what is the diagnostic investigation for giant cell arteritis?
and how is it treated?
temporal artery biopsy
prednisolone
what is giant cell arteritis?
vasculitis of the large vessels
what condition is a saddle shaped nose found in?
granulomatosis with polyangitis
ANCA associated vasculitis
what are the ANCA associated vasculitis conditions?
granulomatosis with polyangitis
microscopic polyangitis
eosinophilic granulomatosis with polyangitis
what vessels does granulomatosis with polyangitis (Wegner’s) affect?
medium/large vessels of mainly the upper and lower respiratory tract (pulmonary haemorrhage)
what type of vessels does microscopic polyangitis affect?
small vessels
necrotising arteritis may be found in medium and small vessels
what is eosinophilic granulomatosis with polyangitis? (churg strauss)
eosinophil rich and necrotising granulomatous inflammation involving the respiratory tract
associated with asthma and eosinophilia
what are the specific ANA profiles in SLE?
anti - dsDNA antibody
anti- Ro antibody
anti- Smith antibody
what are the specific ANA profiles in scleroderma?
anti - Sci-70
anti- centromere
what are the specific ANA profile in polymyositis?
Jo-1
what are the specific ANA profiles in sjogren’s disease?
anti-60 kd Ro
anti- La
would investigations would you carry out if you suspected sjogrens syndrome?
anti-60 kd Ro antibody
anti-La antibody
Schirmer’s test
what investigations would you carry out if you suspected SLE?
ANA, anti-dsDNA, anti-Ro, anti-Smith antibodies FBC protein creatinine ratio urinalysis renal biopsy ESR and CRP complement c3 and c4
what is the treatment for SLE?
NSAIDS + immunosuppression (hydrochloroquine)
what is the treatment for scleroderma?
steroids + immunosuppression (hydrochloroquine)
nifedipine for reynaulds
what ANA is associated with diffuse scleroderma?
anti-sci 70 antibody
what ANA is associated with localised scleroderma?
anti-centromere antibody
