MSS Multisystem Disease Flashcards
Describe how Ab test results have different clinical associations
The anti-nuclear antibody above helps elucidate that there is an immune mechanism, and the type of disease
Below shows that there are specific antibodies that go with definite patterns of disease.
A theme common to multisystem disease is genetics. Further expand on this
what genes can lead to both psiorisis & psioris arthritis VS just psiorisis?
Several gene clusters lead to disease, heritability is a huge factor, even in tendinopathies; eg tennis elbow can run in the family
Describe the genetics of Ankylosing Spondylitis
These findings show the B27 gene is not enough to cause the condition and that there is a polygenetic mode of inheritance
Describe how the microbiome can be linked with Rheumatic diseases
Describe the link between ankylosing spondylitis and the gut
In humans HLAB27 + AS patients have different microbiome to healthy controls
Inflamed gut is where most IL-23 production takes place and this is important in AS
It is possible that the microbiome could be changed to alter disease in future
Side note- periodontitis increases the risk of AS
Describe the mechanisms linked w SLE
Genetic Susceptibility: HLA B8, DR3
C2, C4 deficiencies
Environmental Triggers: UV Light
Virus: EBV
Drugs
Smoking
Female Preponderance: Oestrogens
Why do we target specific cytokines to reduce arthritis risk?
Can someone’s blood result indicate if they have an autoimmune condition like SLE even before they develop symptoms?
Many SLE patients had >1 autoab present ~3.3 yrs pre-diagnosis
ANA/dsDNA/apL appear earlier than anti-RNP and anti-Sm
A trigger that causes the disease, e.g. lupus may be UV exposure, virus.
based on this concept we could prophylactically treat SLE e.g. using antimalaria drug Plaquenil
What is the link between CVD and Lupus?
What is the link between PAH and scleroderma?
Pulmonary artery hypertension is much more common in patients with scleroderma
* PAH found in 8-12% of systemic sclerosis, causes 30% deaths
Psoriasis severity is associated with…
How can multisystem disease affect the lungs?
How can multisystem disease affect the skin?
lupus panniculitis dissolves fat under skin and causes tethering
How can SLE impact the joints and how is this clinical manifestation different to RA?
Side note: lupus, steroid use or thrombosis can also cause osteonecrosis which affects the joints as well
How can scleroderma cause kidney problems?
Scleroderma can cause renal crisis with hypertension
What is neuropsychiatric lupus?
How can scleroderma impact the gut?
Less common manifestations of multisystem
autoimmune disease?
