Connective tissue 2 Flashcards
Arthralgia
Joint pains
Arthritis
Joint inflammation
What are symtoms of autoimmune disease?
Arthralgia/arthiritis Fatigue Myalgia,muscle weakness Sicca symptoms Raynaud's phenomenon Alopecia Mucosal ulcers Unprovoked thrombosis/pregnancy losses/difficult pregnancy history
Female to male ratio is 9:1 T/F
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What is APS characterised by?
Venous or arterial thrombosis and/or adverse pregnancy outcomes in the presence of persistent lab evidence on aPL
Can be primary or secondary
Antibodies to phospholipid binding proteins
Presence of Anti cardiolipin antibody. Lupus
What are the core clinical problems around CTD
Abnormal blood test results Cold extermities Joint pain/swelling Muscle pain Painful or uncomfortable mouth Rash Red/painful eyes Shortness of breath
When would you suspect APS?
Occurrence of one or more otherwise unexplained venous or arterial events, esp in young patients
Foetal death after 10 weeks, premature brith due to severe pre-eclampsia or placental insufficiency or multiple embryonic losses ( less than 10 weeks gestation)
Otherwise unexplained thrombocytopenia or prolonged Aptt
What antibodies are important in APS?
IgM or IgG anticardiolipin
Lupus anticoagulants
IgM or IgG beta 2 glycoproteins
2 positive tests more than 12 weeks apart- confirmatory
1-5% of healthy individuals can have these antibodies
Treatment for APS
Lifelong anticoagulation for thrombosis
Aspirin/heparin to prevent pregnancy complications
Hydroxychloroquine
What is Sjogren’s syndrome?
Chronic autoimmune inflamatory disorder characterised by diminished lacrimal and salivary gland function resulting in dry eyes, dry mouth
Can be primary or secondary
Most common in women in 50s and 60s
Extra-glandular involvement
What are the symptoms of Sjogren’s
Dry eyes-gritty feeling Dry mouth Dry throat Vaginal dryness Bilateral parotid gland enlargement Joint pains Fatigue Unexplained increase in dental caries
What antibodies are important in Sjogrens?
Anti-Ro Anti-La also watch out for IgG,ESR and rheumatoid factor Other tests: -Salivary gland US -Labial gland biopsy
What treatments can be used for Sjogrens?
Artificial tear supplements Ciclosporin eye dros Punctal plugs Saliva supplements Pilocarpine Hydroxychloroquine Immunosuppression with methotrexate, leflunomide, B cell depletes etc if major organ involvement
What can systemic sclerosis be split into?
FIbrosis
Vacular endothelial changes
Diffuse cutaneous systemic sclerosis
Skin involvement proximal to forearms and involving torso
Rapid skin changes
Early organ involvement
Intestitial lung disease more common than pulmonary hypertension
Renal crisis can occur
Anti-topoisomerase or anti SCL-70 or anti RNA III polymerase antibody
