Autoimmune Disease Flashcards
(36 cards)
What are autoimmune diseases?
Conditions where the immune system attacks the body’s own tissues.
List common autoimmune diseases.
-Rheumatoid arthritis
-lupus
-inflammatory bowel disease (IBD)
-Hashimoto’s thyroiditis
-Graves’ disease
-psoriasis.
List less common autoimmune diseases seen in physical therapy.
-Multiple sclerosis
-Guillain-Barre syndrome
-myasthenia gravis
What are the possible causes of autoimmune diseases?
Genetics: Linked to immunoglobulin, T-cell receptor, and MHC complex genes.
Environmental Factors: Exposure to viruses, bacteria, or toxins.
Hormonal Factors: Hormonal changes, especially in women, may play a role.
Define Guillain-Barré syndrome (GBS)
An acute paralytic polyneuropathy affecting the peripheral nervous system.
What is the pathophysiology of GBS?
Caused by molecular mimicry
What is molecular mimicry?
It is a process where B cells produce antibodies against antigens from a triggering pathogen. These antibodies mistakenly recognize and bind to similar proteins on peripheral neurons, potentially damaging the myelin sheath or the nerve axon.
What is the clinical presentation of GBS?
-Symptoms usually start within four
weeks of what is thought as a triggering
infection from either a virus or bacteria
(e.g. infection with “campylobacter”
which is a type of bacteria found in
undercooked poultry).
-They begin in the feet and progress
upward (ascending).
-Symptoms peak within 2-4 weeks. Then,
there is a recovery period that can last
months to years.
Characteristic features of GBS
• Symmetrical ascending weakness
• Reduced reflexes
• Peripheral loss of sensation
• Neuropathic pain
• May progress to cranial nerves and
cause facial paralysis
• Autonomic dysfunction may cause
urinary retention or heart arrhythmias
What is the primary diagnostic tool for GBS?
Brighton criteria, which helps diagnose GBS and help distinguish between low-risk and high-risk patients.
Brighton criteria is supported by further investigations such as?
-Nerve conduction study (NCS) : Reduced
nerve signal
-Lumbar puncture : To test cerebrospinal fluid
protein count → High protein level with
normal cell count
What is the leading cause of death in patients with GBS?
Pulmonary embolism due to immobilization
How is GBS managed?
-First-line treatment: IV immunoglobulins (IVIG).
• Alternative: Plasmapheresis.
-Supportive care: Pain management, physical therapy, and VTE prophylaxis (anticoagulant).
What is prognosis of GBS usually like?
-Recovery can take months to years. Patients can continue regaining function five years after
onset.
-Most patients make a full recovery or are left with minor symptoms.
-Some are left with significant disability.
In GBS mortality is approximately 5% mainly due to?
respiratory or cardiovascular complications.
Define myasthenia gravis.
An autoimmune condition affecting the neuromuscular junction.
MG affects men and women at different ages, what is the typical age for each?
affecting women under 40 and men over 60
There is a strong link between myasthenia Gravis
and what disease?
thymomas (thymus gland tumors)
What is the pathophysiology of MG?
acetylcholine receptor (AChR) antibodies are found. These antibodies bind to the postsynaptic acetylcholine receptors, blocking them and preventing stimulation by acetylcholine.
What is the effect of activity vs rest in patients with MG?
-The more the receptors are used during muscle activity, the more they become blocked. There is less effective stimulation of the muscle with
increased activity.
-With rest, the receptors are cleared, and the
symptoms improve.
Antibodies cause cell damage at the postsynaptic
membrane, further worsening symptoms of MG, why?
Because these antibodies also activate the complement system within the neuromuscular junction
