Type III Flashcards
Immune Complex Reactions
-
Antigen-antibody complexes formed in circulation & deposited later in vessel walls or other tissue (kidney, vessels, skin, joints)
> IgG & IgM antibody-antigen immune complexes in circulation -
Harmful effects caused by complement cascade activation
> attracts neutrophils
> unsuccessful phagocytosis
> release of lysosomal enzymes into inflamm site; incrs inflamm reaction - EX: rheumatoid arthritis, lupus
Autoimmune Diseases
-
Production of antibodies against the body’s own cells; destructed inflammatory process
> both antibody and cell-mediated responses & products are directed against normal body cells -
Autoimmune disorders overlap
> more than one disorder tend to occur -
Women most commonly affected
> can affect all ages and gender
Autoimmune - Connective Tissue Disorders
-
Primary target 2 major structural protein molecules
> Elastin: major component of ligaments & skin
> Collagen: component of tissues & blood vessels
Connective Tissue Disorders - Classic Diseases
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus
- Scleroderma
- many others
Rheumatoid Arthritis (RA)
-
Damage to joints bilaterally & symmetrically
> women of child bearing years
> phases of exacerbations & remission
> triggers (physical & emotional stress)
Rheumatoid Arthritis (RA) - CMs
-
Difficult to rise in AM
> pain, stiffness - Joint pain/deformities
- Rheumatoid nodules
- Systemic
Rheumatoid Arthritis (RA) - Diagnosis Criteria
American Rheumatism Association
-
4 of 7 for diagnosis
> morning stiffness greater than 1hr for 6wk duration
> soft tissue swelling of wrist, metacepophalangeal or proximal interphalangeal joints for 6 wk duration
> symmetric soft tissue swelling
> rheumatoid nodules
> positive serum rheumatoid factor test
> radiographic changes in hands or wrist joints
Systemic Lupus Erythematosus
Red = Erythematosus Lupus = Wolf (Red Wolf)
- Immune complexes invade organs
- Characterized by variability
> mild to severe
> women in childbearing yrs
> phases of exacerbation & remissions
Systemic Lupus Erythematosus - Triggers
-
Hormones
> menses/pregnancy exacerbate disease - Sun exposure
- Infections
- Drugs/meds
Systemic Lupus Erythematosus - Diagnosis Criteria
-
4 or more serially or simultaneously
> malar rash (butterfly)
> discoid tash
> photosensitivity
> oral ulcers
> arthritis (usually non-deforming)
> ANA titer abnormal (>20)
> Serositis (pleuritis/pericarditis)
> other organ involvement
Scleroderma (systemic sclerosis)
“Disease turns pt to stone”
- Inflammation & progressive tissue fibrosis & occlusion of microvasculature by collagen
> african american
> women middle age
> exacerbation/remissions
Scleroderma (systemic sclerosis) - 2 Types
-
Limited cutaneous disease
> most common
> symmetric skin thickening limited to distal extremities & face -
Diffuse cutaneous disease
> organ involvement
Scleroderma (systemic sclerosis) - CMs
-
Raynaud’s
> early sign 90% -
Skin hardening
> sclerodactyly (stiff fingers) -
Telangiectasias
> dilated superficial blood vessels - Heartburn/dysphagia
- Joint pain
- Pulmonary fibrosis
-
Anti-centromere antibody
> SCL-70 (scleroderma antibody 35%)
Autoimmune Connective Tissue Diseases - Diagnostic Tests
-
Specialized blood tests
> RA factor, ANA, LE prep, complement lvls - CBC/chemistry
- Liver/renal function
- X-ray joints
- Chest x-ray
- ECG
Autoimmune Connective Tissue Disease - Medical Treatment
- NO cure
- Pain control
- Meds: immunosuppressive
- Physical therpay
- Diet high in calories / vits
- Joint support
-
Surgery
> correct deformity, restore function
