Systemic Autoimmune Disease 2 Flashcards
Dermatomyositis, Polymyositis, and Inclusion Body Myositis are grouped together why?
They are inflammatory myopathies
Inflammatory myopathies are what?
Group of disorders characterized by immune mediated damage and inflammation of skeletal muscles
Classical rash of dermatomyositis (DM)?
Classic rash of upper eyelids with periorbital edema
What is Grotton’s lesion in DM?
Erythematous eruption over knuckles, elbows, and knees
How do muscles present in DM?
Symmetric weakening of muscles of proximal muscles first
What is Polymyositis?
Inflammatory myopathy that involves symmetric proximal muscles and occurs mainly in adults
What is Inclusion Body myositis (IBM)?
Distal muscle involvement that can be asymmetric
What causes DM?
Immunologic injury to microvasculature mediated by antibodies and complement resulting in myocyte necrosis. B-Cell mediated
What causes Polymyositis/IBM?
Cell mediated, CD8 T-cells with increased MHC1 expression
Biggest problem with these inflammatory group?
Difficulty moving
How do you diagnose these inflammatory problems?
BIOPSY, creatine kinase levels
Special pathologic feature for DM?
Inflammatory infiltrates around small blood vessels
Special pathologic feature for Polymyositis?
Direct injury to myofibers by CD8 without evidence of vascular injury
Special pathologic feature for IBM?
Presence of rimmed vacuoles within myocytes
What disease is characterized by widespread musculoskeletal pain/stiffness with multiple tender points, easy fatigability and non-restorative sleep
Fibromyalgia
Fibromyalgia involves what in the CSF?
Decreased Serotonin
Low Somatomedin C
Increased Neurotransmitter substance P
True or false fibromyalgia is more likely metabolic and neurological than inflammatory or structural?
True
What sites can be used as control sites (no tenderness) to test for fibromyalgia?
Dorsum of 3rd digit between PIP and DIP
Medial third of clavicle
Medial malleolus
Forehead
What causes inflammation in Serum Sickness?
Immune complexes activate complement which triggers inflammation
Kawasaki disease is what type of immune damage reaction and what does it target?
Anti-endothelial cell antibodies
Type 2
Goodpoasture’s syndrome is what type of immune reaction and what’s it target?
Anti-basement membrane antibodies
Type 2
Antineutrophil Cytoplasmic antibodies (ANCA) signify what type 2 reaction?
Polyarteritis nodosa
Wegener’s
Type 3 immune complexes (3)?
DNA anti-DNA immune complexes in SLE
Mixed cryoglobulinemia with IgG, IgM and complement
HBsAg-anti HBsAg immune complexes
Type 4 disease involving granulomas?
Granulomatous arteritis
What is erythema multiform?
Uncommon self limited lesions involving skin and subcutaneous tissue associated with drugs and infections
What is Erythema nodosum?
Panniculitis, inflammation of subcutaneous tissue associated with infections, drugs and no obvious vasculitis
Infiltrates of Erythema Nodosum?
Lymphocytes, histiocytes, and multinucleated giant cells
What is Erythema induratum?
Primary vasculitis of deep vessels in subcutaneous tissues
Necrosis and inflammation within fat
Associated with hypersensitivity to TB
