Term
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Definition
| exists when the immune system fails to recognize the body's own cells, and begins to attack them as if they were foreign. |
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Term
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Definition
| are diseases caused by the body producing an inappropriate immune response against it's own tissues? |
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Term
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Definition
| Antibodies that attack it's own cells, tissues, and/or organs. This causes inflammation and damage and it leads to autoimmune disorders. |
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Term
| What are the two general types of Autoimmune Disorders? |
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Definition
Systemic - Those that damage many organs
Localized - Those where only a single organ or tissue is directly damaged by the autoimmune process. |
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Term
| Examples of Systemic Autoimmune Diseases |
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Definition
- RA and Juvenile RA
- lupus
- Scleroderma
- Sjögren's Syndrome
- Goodpasture's Syndrome
- Wegener's Granulomatosis
- Polymyalgia Rheumatica
- Guillain-Barre Syndrome
- Multiple Sclerosis
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Term
| Examples of Localized Autoimmune Disease |
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Definition
- Type 1 diabetes mellitus (Pancreas islets)
- Hashimoto's Thyroiditis & Graves Disease (Thyroid)
- Celiac Disease, Crohn's Disease, & Ulcerative Colitis (GI Tract)
- Addison's Disease (adrenal)
- Primary Biliary Cirrhosis, Sclerosing Cholangitis, Autoimmune Hepatitis (Liver)
- Temporal Arteritis, Giant Cell Arteritis (Arteries of the head and neck)
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Term
| Autoimmune disease is usually prevented by the normal function of what mechanisms? |
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Definition
| immunologic regulatory mechanisms |
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Term
| What can happen when the immunologic regulatory mechanisms malfunction? |
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Definition
| Antibodies to self antigens may be produced, and bind to antigens in the circulation to form circulating immune complexes, or bind to antigens deposited in specific tissue sites. |
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Term
| What are some causes of autoimmune responses? |
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Definition
- Antigens that do not normally circulate in the blood
- Altered antigens
- A foreign antigen that is shared or cross-reactive with self-antigens or tissue components.
- Mutation of immunocompetent cells (WBCs) to acquire a response to self-antigens
- Loss of the immunoregulatory function by T-cell subsets
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Term
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Definition
| is a progressive inflammatory disease of the joints, the disease can be very mild or severe. |
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Term
| Destructive Polyarthritis |
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Definition
| Severe cases of Rheumatoid Arthritis can manifest as a destructive polyarthritis where the hands and feet are severely deformed. |
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Term
| What are the serological findings of RA? |
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Definition
Low serum iron and low or normal iron-binding capacity, mild to moderate decrease in serum albumin, durring the accute and chronic phases the following are usually elevated;
- Erythrocyte sedimentation rate
- Gamma globulins (commonly IgM & IgG)
- Platelet count roughly in proportion to the severity of overall joint inflammation.
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Term
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Definition
| An IgM antibody that reacts against a patient's own IgG antibodies, demonstrable in 70-80% of patients with RA, not a cause of RA but produced during the course of the disease, high titers associated with severe rheumatoid disease. |
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Term
| Antinuclear Antibodies (RA) |
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Definition
| Demostrable in 20% of RA patients, titers lower than in SLE (systemic lupus erythematosus) |
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Term
| Complement levels in RA patients |
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Definition
Usually normal except in those with vasculitis, depressed hymolytic complement levels:
- Found in less than 1/3 patients
- Usually found in patients with very high levels of rheumatoid factor (RF) and immune complexes
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Term
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Definition
- Association of RA with splenomegaly and leukopenia
- Almost always develops in patients with a high titer rheumatoid factor assay, a positive antinuclear antibodies (ANA) assay, and rheumatoid nodules
- Joint fluid examination is valuable, reflecting abnormalities that are correlated with varying degrees of inflammation.
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Term
| What are the two most common autoimmune diseases that affect the thyroid? |
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Definition
Hashimoto's thyroiditis
Grave's disease |
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Term
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Definition
- Thyroiditis - Inflammation of the thyroid gland
- Hypothyroidism - Underactive thyroid
- Large and rubbery thyroid gland (goiter)
- Symptoms of hypothyroidism:
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Term
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Definition
- Manifests by overproduction of thyroid hormones
- Goiter that is soft instead of rubbery
- Leads to hyperthyroidism (overactive thyroid)
- Symptoms of Graves Disease:
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Term
| Important proteins, enzyme, and hormones of the thyroid include: |
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Definition
- Thyroglobulin
- Thyroid peroxidase (TPO)
- Thyroid stimulating hormone (TSH)
- Triiodothyronine (T3) Thyroxine hormones(T4)
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Term
(Hashimoto's Thryroiditis)
Hormone test |
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Definition
- Slight increase in the plasma TSH concentration (early phase)
- Fall of thyroid hormones T4 and serum T3 (later phases)
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Term
| Hashimoto's Thyroiditis - Antibody test |
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Definition
The following autoantibodies found in moderate to high titers in 50% of patients.
- Antithyroglobulin
- Antimicrosomal antibodies (considered more diagnostic)
- More than 90% have anti-TPO (autoantibody to TPO)
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Term
| Grave's Disease - Hormone test |
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Definition
Decreased levels of TSH, Elevated levels of hormones T3 and T4.
Increased uptake of radioactive iodine (confirmatory test)
Anti-TPO antibodies found in 50% of patients. |
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Term
| SLE - Systemic Lupus Erythematosus |
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Definition
Classic model of autoimmune disease
Chronic systematic inflammatory disease
1 in 2000 (trippled over last 40 yrs)
Mostly affects women
Onset usually between 20-40 years
Usually follows a chronic and irregular course with periods of exacerbations and remissions. |
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Term
| What is the most common cause of death in patients with SLE? |
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Definition
| Renal failure and infectious complications. |
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Term
| What are the early signs of SLE? |
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Definition
| Fatigue, weight loss, malaise fever, and loss of appetite. |
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Term
| In SLE patients, what happens to the joints? |
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Definition
| 90% of patients have joint pain or arthritis. |
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Term
| In SLE patients, some patients develop a butterfly rash, what percentage of patients get this rash and where is it located? |
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Definition
| Butterfly rash is a rash across the nose and cheeks, and is seen in more than 40% of patients. |
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Term
| Patients with SLE have an increased risk of developing __________ and _________ _________. |
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Definition
| common and opportunistic infections. |
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Term
| SLE can involve the following systems; |
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Definition
Renal
Cardiovascular
Gastrointestinal
Nervous
Musculoskeletel |
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Term
| What is the hallmark autoantibody of systemic lupus erythematosus (SLE)? |
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Definition
| Antinuclear Antibodies (ANA) |
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Term
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Definition
| (True autoantibodies) Heterogeneous group of immunoglobulins (IgM, IgG, and IgA) that react with whole nucleus or nuclear components such as DNA and nuclear proteins. Found in other diseases such as RA. |
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Term
| What are the potential blood test findings associated with SLE? |
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Definition
Moderate anemia
Lymphocytopenia
Thrombocytopenia |
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Term
| What are the serological manifestations associated with SLE? |
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Definition
High levels of ANAs
Immune Complexes
Complement level depression
Tissue deposition of Igs and complement
Other autoantibodies. |
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