Multi system autoimmune disease Flashcards
Who is systemic lupus erythematous seen in?
Females > males
Onset 15-50
What are the classical signs and symptoms of lupus?
Fatigue, fever Myalgia and arthralgia Raynaud's Butterfly rash Photosensitivity
What are the classification criteria of lupus?
Any 4 of- Butterfly rash Discoid rash Photosensitivity Oral ulcers Arthritis Serositis Proteinuria Cellular casts in urine Unexplained seizures/psychosis Anaemia Low WCC Antinuclear antibodies
What investigations are done for lupus?
Antibody tests- ANA, anti-dsDNA, Ro, Smith
What is the treatment of lupus?
Immune suppressants
What are the types of scleroderma?
Limited
Diffuse
Who is scleroderma seen in?
Females > males
Onset 30-50
What are the signs and symptoms of scleroderma?
CREST Calcinosis Raynaud's Eosophageal dysmotility Sclerodactyly- swelling of fingers Telangiectasia- visible small blood vessels
What are the investigations for scleroderma?
Antibodies-
ANA,
Diffuse= Scl-70,
Limited= centromere
What are the possible complications of scleroderma?
Limited- pulmonary hypertension
Diffuse- pulmonary fibrosis, renal crisis
Small bowel bacterial overgrowth
What is Sjogren’s syndrome?
Mildest an host common connective tissue autoimmune disease
Who is Sjogren’s syndrome seen in?
Female > male
Onset 40-50
What are the signs and symptoms of Sjogren’s syndrome?
Dry eyes and mouth
Parotid gland enlargement
Systemic- fatigue, fever, myalgia and arthralgia
What investigations are done for Sjogren’s syndrome?
Anibodies- Ro, La
What are the possible complications of Sjogren’s syndrome?
Lymphoma Neuropathy Purpura Interstitial lung disease Renal tubular acidosis
What are the types of Autoimmune myositis?
Polymyosisits
Dermatomyositis
What antibodies are present in autoimmune myositis?
Anti Jo-1 antibodies
Who does dermatomyositis affect and what is it often a sign of?
Affects older people
Often presentation of cancer as paraneoplastic syndrome
What are the manifestations of dermatomyositis?
Gottron’s papules- scaly rash on knuckles
Heliotrope rash- violet discolouration around eyes
What are the signs and symptoms of autoimmune myositis?
Muscle weakness- diffuse, symmetrical and proximal
What are the possible complications of autoimmune myositis?
Cancer
Interstitial lung disease
What are the types of systemic vasculitis?
Giant cell arteritis
ANCA associated vasculitis
What is the classification of giant cell arteritis?
3 of- Age >50 New headache Temporal artery renderness ESR > 50 Abnormal temporal biopsy
What are the types of ANCA associated vasculitis?
Granulomatosis with polyangitis
Microscopic polyangitis
Eosinophilic granulomatosis with polyangitis
What is granulotomatosis with polyangitis
Necrotising granulomatous inflammation
Usually involving upper and lower respiratory tract
Affects small to medium vessels
Necrotising glomerulonephritis common
What is microscopic polyangitis?
Necrotising vasculitis with few or no immune deposits and no granulomatous inflammation
Mainly affects small vessels
Necrotising glomerulonephritis very common
What is eosinophilic gramulomatosis with polyangitis?
Eosinophil rich and necrotising granulomatous inflammation
Often involves res tract
Mainly affects small to medium vessels
Associated with asthma and eosinophilia
