Autoimmune Diseases Flashcards
What is Sarcoidosis?
Multisystem granulomatous inflammatory disorder characterised by the presence of non-caesating granulomas
Common in Afro-Caribbeans and Scandinavians
How does Sarcoidosis typically present?
Fever, Malaise, Weight Loss
SOB, Dry Cough
Arthralgia
Uveitis, Keratoconjunctivitis
Erythema Nodosum
How would you investigate potential Sarcoidosis?
Bloods - Hypercalcaemia, High ACE, High ESR
CXR - Bilateral Hilar Lymphadenopathy, Pulmonary Fibrosis
Biopsy - Non-Caeseating Granulomas
How do you manage Sarcoidosis?
Steroids
NSAIDs
Steroid-sparing agents
How does SLE typically present?
Serositis
Oral Ulcers
Arthritis
Photosensitivity
Bloods
Renal
ANA
Neurological
Malar Rash
Discoid Rash
SOAP BRAIN MD
How would you investigate a potential case of Lupus?
Bloods - High ESR, U&E, FBC
Autoantibodies - Anti-dsNA, ANA, Anti-cardiolipin
Urine - casts, proteinuria, haematuria
CXR
What is Anti-Phospholipid Syndrome?
Complication of SLE
Triad: Thromboembolism, Recurrent Miscarriage, Thrombocytopaenia
Anti-Cardiolipin
What is Systemic Sclerosis (Scleroderma)?
Rare connective tissue disease characterised by widespread blood vessel damage and fibrosis in skin and internal organs.
How does Diffuse Cutaneous Scleroderma typically present?
Skin Changes (Including the trunk)
Raynaud’s
Tendon Friction
Early Lung Disease
Heart, GI, Renal DIsease
Which antibody is associated with Diffuse Curtaneous Scleroderma?
Anti-Topoisomerase II
(Anti-Scl-70)
How does Limited Scleroderma typically present?
CREST Syndrome
Calcinosis
Raynaud’s
Esophageal Dysmotility
Sclerodactyl
Telangiectasia
Which antibody is associated with Limited Cutaneous Scleroderma?
Anti-Centromere
What is Vasculitis?
Inflammation of the walls of blood vessels.
What are the main types of Vasculitis?
Large-Vessel
Giant Cell Arteritis
Polymyalgia Rheumatica
Medium-Vessel
Polyarteritis Nodosa
Small-Vessel
Behcet’s
Granulomatosis with Polyangitis (Wegener’s)
Eosinophilic Granulomatosis with Polyangitis (Churg-Strauss)
Which condition is strongly associated with Giant Cell Arteritis?
Polymyalgia Rheumatica (Shoulder/Pelvic Girdle Frame)
What are the main symptoms of Giant Cell Arteritis?
Unilateral Headache
Jaw Claudication
Scalp Tenderness
Vision Loss
Systemic Upset
How do you investigate and manage a suspected case of Giant Cell Arteritis?
ESR (Raised)
High Dose Oral Prednisolone
Temporal Artery Biopsy (Skip Lesions)
What is Polymyalgia Rheumatica?
An Inflammatory condition characterised by severe bilateral pain and morning stiffness of the Shoulder, Neck and Pelvic Girdle.
Weakness is not a factor.
How would you investigate and manage a case of Polymyalgia Rheumatica?
Raised ESR/CRP
Oral Steroids
What is Polyarteritis Nodosa?
Medium-Vessel Vasculitis
How does Polyarteritis Nodosa typically present?
Background of Hepatitis B
Constitutional Upset
Skin Rash
Abdo Pain
Rectal bleeding
Peripheral Neuropathy
Renal Failure
Hypertension
‘Rosary Sign’ on angiogram
How does Granulomatosis with Polyangitis typically present?
Triad of:
URT Symptoms (Nose bleeds, rhinitis)
LRT Symptoms (Haemoptysis)
Kidney Disease (Glomerulonephritis)
‘Saddle Nose’
How would you investgate a suspected case of Granulomatosis with Polyangitis?
cANCA
Cavitating Lesions on CXR
How does Eosinophilic Granulomatosis with polyangitis typically present?
Tri-Phasic
Allergic Phase - Asthma/Rhinitis
Eosinophilic Phase - Tissue damage (Typically lungs & GI)
Vasculitic Phase - Widespread Organ Death
Other - Haemoptysis, Rash, Focal Neuropathy, Kidney Damage
How would you investigate a suspected case of Eosinophilic Granulomatosis with Polyangitis?
pANCA
How does Behcet’s Typically present?
Triad of:
Oral Ulcers
Genital Ulcers
Uveitis
Other - Erythema Nodosum, Arthritis, Pericarditis, Colitis
How would you investigate a suspected case of Behcet’s?
Clinical Mainly
‘Pathergy Test’ - Sterile pustule develops post-needle prick
How does Takasayu’s Arteritis typically present?
Inflammatory Phase - FLAWS
Pulseless Phase - Eak/absent pulses, claudication
Which HLA serotype is Behcet’s associated with?
HLA-B51
