Autoimmune Rheumatic Diseases - 5 Flashcards
outline autoimmune rheumatic diseases
Immune tolerance breakdown
• Production of pathogenic antibodies
• Multisystemic features
they include rheumatoid arthritis SLE Sjorgens Systemic slcerosis
why is monitoring levels of autoantibodies key ?
Aid to diagnosis
• Associated with specific clinical features
• Disease prognosis
• To stratify therapy
what are key indicatiors of luus (SLE)
- Female to male ratio: 9:1
- Race: Afro-Caribbean > South Asians > Caucasians
genetics/ family history
enviromental - sunny trip and smoking trigger/exacerbate
SLE is a systemic ilness that can cause a whole range of issues
list some (NOT ALL)
Raynauds Joint pains and swelling Hand rash Proximal muscle weakness > Myalgia Hair loss Eye and mouth dryness Nose bleeds Mouth ulcers Pleuritic chest pain Pericardial pain Truncal Rash/Photosensitivity Limb weakness
what investigations do we run for ARD’s
Routine bloods Full blood count Urea, electrolytes and creatinine Liver enzymes C-reactive protein Plasma viscosity and ESR Complements
Lupus assoc. bloods Antinuclear antibodies (≥1:160) Anti-DsDNA antibodies Anti-Sm antibodies Anti Ro and La antibodies complements Antiphospholipid antibodies
Lupus Mnemonic
A RASH POINTS Medical Diagnosis
ANA positive Renal abnormalities Arthralgia/arthritis Serositis Haematologic abnormalities
Photosensitivity Oral ulcers Immunological abnormalities Neurologic abnormalities Malar rash / Discoid Rash
4 out of 11 criteria items= Definite Lupus
what are key indicatiors of rheumatoid arthritis
Female to male ratio: 3:1
• No race predilection
genetic and environmental factors
some symptoms of rheumatoid arthritis are
painful bilateral hand joints joint pain and swelling disabling fatigue. squeezing joints is painful early morning stiffness
Involvement of other systems
• Skin, eye, lung
• Malaise, weight loss, fevers, night sweats?
rheumatoid arthritis tests
do not need to know this off by heart
Routine tests Full blood count Urea, electrolytes and creatinine Liver enzymes C-reactive protein Plasma viscosity and ESR X-rays ± Ultrasound
Autoantibodies Antinuclear antibodies Rheumatoid factor antibodies Anti-CCP antibodies Anti Ro and La antibodies
