A/43 Flashcards
(29 cards)
2 characteristics of SLE
- multisystem disorder
- remitting/relapsing disease : ondulant
What type of autoantibodies can you find in SLE? (3)
- Antinuclear antibodies
- Antibodies to blood cells
- Antibodies to phospholipids
What is the anti-smith antibody?
auti-antibody against double strand DNA, found specifically in SLE
How do we detect ANA in lupus?
immunofluorescence test - different patterns depending on which region of the cell is affected
Limitations of testing for ANA (2)
- low specificity : other autoimmune disorders can also be positive
- 5-15% old healthy people can be positive too
Incidence of SLE (3)
- 1/250 people prevalence
- 9:1 female / male ratio
- Disease of the 30s
What do the antibodies to phospholipids affect in SLE?
blood clotting : patients more prone to venous thrombus and thrombocytopenia
Pathomechanisms of SLE (3)
- Type 3 HS : DNA/antiDNA complexes
- Type 2 HS : antibodies to RBC, platelets
- Antibodies to clotting system
Genetic factors of SLE pathogenesis (4)
- familiar accumulation
- HLA-DR2 and HLA-DR3 are the most prone
- Genetic deffect of C1q, C2, C4
- Deffective clearance of immune complexes
Most affected systems by SLE (7)
- Vessels
- Skin
- Joints
- Kidney
- Heart
- Serosal membranes
- CNS
Morphology of SLE on the vessels
Acute necrotizing vasculitis of small arteries and arterioles
Morphology of SLE on the skin (2)
- Butterfly erythema
- Maculopapular eruption
Morphology of SLE on kidney (2)
- Endothelial, mesangial, epithelial proliferation caused by inflammation
- Glomerulonephritis due to IC deposits
Morphology of SLE on heart (2)
- Libmen-Sacks endocarditis
- AS
Morphology of SLE on CNS (2)
- Cerebral microinfarcts
- Neurologic / psychiatric manifestations
SLE therapy
immunosuppression, steroids
Incidence of RA (2)
- Peak incidence 40-50 years
- 5:1 female / male ratio
What type of auto-antibodies in RA?
anti-citrullinated protein antibodies (ACPA)
What is rheuma factor?
IgM/A autoantibodies against Fc receptor of IgG
What does rheumatoid arthritis mostly cause? (2)
- Non suppurative, proliferative, symmetric synovitis of small joints
- Destruction of articular surface
Factors that affect incidence of RA? (2)
- Genetic factors : HLA-DR4 allele
- Environmental triggers
Pathomechanism of RA? (3)
- CD4 is activated by binding MHCII
- CD4 induces macrophages to release cytokines
- Cytokines induce MMP, RANKL, RF production and proliferation of fibroblasts and synovia
What do MMPs do?
Destroy tissue
What does RANKL do?
Osteoblast proliferation, which leads to bone destruction
