Auto-Immunity Flashcards

1
Q

What is autoimmunity?

A

Immune response against the host due to loss of immunological tolerance to self antigens.

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2
Q

What is autoimmune disease?

A

Disease caused by tissue damage due to autoimmune response.

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3
Q

What are the two categories?

A

Organ specific - antigens within specific organ/tissue

Non-organ specific - antigens throughout the body

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4
Q

Give some examples of organ specific diseases.

A
Thyroid - hashimoto's, graves', addison's
Pancreas - T1DM
Myasthenia gravis
MS
Goodpastures
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5
Q

Give some examples of non-specific diseases.

A

Autoimmune haemolytic anaemia.
Rheumatoid arthritis
SLE

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6
Q

How does autoimmunity cause disease?

A

Complement activation
Antibody mediated cell cytotoxicity
Neutrophil activation
Cytotoxic T cells

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7
Q

What 2 things must be considered in autoimmune serology?

A

Sensitivity - how many who have disease will have auto-antibody.
Specificity

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8
Q

How are antibodies transferred to the foetus?

A

IgG in T3

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9
Q

If mum has auto-immune disease, will the baby?

A

Possibly.
Varying risk with each condition.
Graves - 10%

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10
Q

What triggers autoimmunity?

A

Genetic Factors

Environmental Factors - hormones, infections, drugs

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11
Q

What infection is characterised by an immune reaction against antigen in cardiac muscle?

A

Rheumatic fevere

Strep pyogenes - M protein

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12
Q

Which other diseases can be caused by infection?

A

Guillain-Barre syndrome

Diabetes type 1

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13
Q

What treatment can be used against auto-immune conditions?

A
Plasmapheresis
Immunosuppression
Anti-inflammatory drugs
Replacement therapy
Surgery
Monoclonal antibodies
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14
Q

What are monoclonal antibodies?

A

Antibodies which all bind to the same epitope on an antigen.

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15
Q

What is the criteria for diagnosing autoimmune disease (6)?

A
  1. Presence of auto-antibodies/autoreactive T cells
  2. Levels of antibodies correlate with disease severity
  3. Autoantibodies/autoreactive T cells found at site of tissue damage
  4. Transfer of auto-antibody or autoreactive T cell to healthy host induces autoimmune disease
  5. Clinical benefit from immunomodulatory therapy
  6. Family History
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16
Q

Give three examples where IgG transfer from mother to fetes can cause autoimmune disease in newborn?

A

Graves - TSH receptor antibody
Haemolytic anaemia - RBC antibody - lysis
Thrombocytopenia - platelet antibody -lysis

17
Q

What is an example of an infection induce autoimmune disease?

A

Strep progenes causes rheumatic fever.

M protein has similar structure to heart muscle antigen. Antibodies cross-react and damage the heart - valves.

18
Q

List symptoms of Graves’ disease.

A
Exophthalmos
Goitre
Tachycardia and palpitations
Sweating
Tremor
Nausea and diarrhoea
Oligomenorrhea 
Weight loss
19
Q

What is the treatment for Graves’ disease?

A

Carbimazole - inhibits thyroid peroxidase
Radioactive iodine
Surgery - thyroidectomy

20
Q

Name two autoantibodies in Hashimoto’s disease.

A

Anti-thyroglobulin

Anti-thyroid peroxidase

21
Q

What type of reaction is Hashimoto’s?

A

Type IV - delayed

22
Q

What are symptoms of Hashimoto’s?

A
Weight gain
Fatigue
Hair loss
Anxiety
Dry skin
Infertility
23
Q

What is a biopsy of the thyroid likely to show in Hashimoto’s disease?

A

Infiltrate of lymphocytes - CD4 and CD8

Plasma cells

24
Q

What is the treatment for hashimoto’s?

A

Replacement therapy with thyroxine