rheum Flashcards
RA
systemic cx: constrictive pericarditis IPF benign nail fold vasculitis Felty's syndrome (splenomegaly, neutropenia, leg ulcers) pyoderma gangrenous peripheral neuropathy
drug induced lupus
- eg TNF-a
- ix; anti-histone ab
Up to 95% of patients have antihistone antibodies, which also are present in more than 50% of patients with SLE.
Antibodies to anti-double-stranded DNA, anti-Smith, antiribonucleoprotein, or anti-Ro/SSA or anti-La/SSB antibodies are typically absent
abs - disease
Microsopic POlyangiitis is associated with anti-MPO antibodies.(pANCA)
Wegener’s: with anti PR3.(cANCA)
Renal limited vasculitis: 70-80% with anti-MPO (pANCA)
Anti Jo-1 + ILD = polymyositis (anti-synthetase syndrome)
symmetric, progressive muscle weakness
Interstitial lung disease may precede myopathy or occur early in the disease, often in association with the presence of antibodies to t-RNA synthetases
limited scleroderma
Anti-centromere Ab
-Centromere antibody protective effect against severe ILD
Cardiac and renal disease is RARE
- Lung disease 30%/ Pulm HT 10%
Telangiectasia is the most common feature
Diffuse scleroderma
Anti-topoisomerase(Scl-70)
-Anti-RNA polymerase III is associated with diffuse cutaneous disease and is the most common immunological marker for renal crisis
Tendon friction rubs is the hallmark feature
systemic sclerosis
NSIP
scleroderma
- common Gi - gord
- ILD –> cyclophosphamide
RA
NO DIP ivlved for RA and SLE
Synovial fluid
RA: WCC 2000-10,000 , PMNs >50%.
septic arthritis: WCC >50,000 and PMNs >75%
Clinical triad of Felty’s syndrome
RA,
Neutropenia (<2.0 x 109/L) and
Splenomegaly.
Hydroxychloroquine
No evidence for slowing of radiographic progression with the use of hydroxychloroquine.
major side effect affecting the eyes and this includes:
1) Maculopathy-reduced visual acuity(dose related)
2) Vortex keratopathy(non dose related)
dermatomyositis
Gottron’s sign heliotrope rash Shawl sign Periungal changes Mechanics hands
3 mandatory fx of PMR
Age >50.
Bilateral shoulder ache.
Abnormal CRP +/- ESR
autoab
Microsopic POlyangiitis is associated with anti-MPO antibodies.(pANCA)
Wegener’s: with anti PR3.(cANCA)
Renal limited vasculitis: 70-80% with anti-MPO (pANCA)