Autoimmunity and Systemic Lupus Erythematosus

Question 1

There are two broad categories of autoimmune disorders: ________________.

Answer 1

organ-specific and systemic

Question 2

Lupus can be either type ___ or ___.

Answer 2

II; III

Question 3

Explain the mnemonic MDSOAPBRAIN.

Answer 3

It lists the symptoms of lupus (four are required for diagnosis): malar rash, discoid rash, serositis, oral ulcers, anti-nuclear antibodies, photosensitivity, blood (anemia) renal dysfunction, arthritis, immunocompromised, neurologic (seizures or psychosis)

Question 4

What is the most common demographic for lupus patients?

Answer 4

Women (9:1), post-pubertal, child bearing, non-caucasian

Question 5

The strongest genetic association with lupus is _______ and the second strongest is _______.

Answer 5

C4 null allele; HLA-DR4

Question 6

Roughly 10% of lupus patients have ___________.

Answer 6

warm autoimmune hemolytic anemia

Question 7

Anti-phospholipid antibody leads to ________ in SLE patients.

Answer 7

increased clotting, by a mechanism that is still poorly understood (because aPL acts against prothrombin activation)

Question 8

Neurologic symptoms appear in ___ percent of SLE patients.

Answer 8

66

Question 9

Renal involvement is present in _______ SLE patients.

Answer 9

nearly all

Question 10

In SLE, B cells are usually ________ and debris is _______.

Answer 10

defectively regulated; slow to be cleared; this results in persistent auto-immunity

Question 11

Describe illicit help.

Answer 11

An antigen-presenting cell shows foreign antigen coupled to self antigen to a CD4 T cell; that T cell can then bind to an autoreactive B cell that is bound to the self part of the antigen.

Question 12

Why are lupus patients anemic?

Answer 12

They have chronic inflammation (which decreases iron absorption and EPO production) and they make IgG to RBC and WBC surface antigens.