Importance of autoantibodies
- aid diagnosis
- associated with specific clinical features
- disease prognosis
- to stratify therapy
Common autoimmune rheumatoid diseases
- systemic lupus erythematosus
- rheumatoid arthritis
Epidemiology of systemic lupus erythematosus
- F:M 9:1
- Afro Caribbean > south Asians > Caucasians
What is Raynaud’s syndrome?
Lack of blood supply to areas of body causes it to feel cold, numb + change colour
Treatment of SLE
- lifestyle modifications e.g sunscreen use
- start disease modifying anti rheumatic drugs: hydroxychloroquine, azathioprine
- steroids: prednisolone + methylprednisolone
- IV cyclophosphamide in severe cases
Diagnosis of lupus
A RASH POINTS Medical Diagnosis
- ANA positive
- Renal abnormalities
- Arthralgia/arthritis
- Serositis
- Haematological abnormalities
- Photosensitvity
- Oral ulcers
- Immunological abnormalities
- Neurological abnormalities
- Thrombocytopenia
- Sclap changes (hair loss, rash)
- Malar rash / Discoid Rash
4/11 points > diagnosis
Epidemiology of rheumatoid arthritis
- F:M 3:1
- 1% prevalence
- no race predilection
Treatment of rheumatoid arthritis
- start disease modifying anti rheumatic drugs: methotrexate hydrochloroquine
- steroids: prednisolone, methylprednisolone
- combination therapy
S factor diagnosis of rheumatoid arthritis
- Stiffness: early morning joint stiffness >30mins
- Swelling
- Squeezing joints is painful
Presentation of rheumatoid arthritis
- affects small joints
- bilateral
- joint pain, swelling + deformities
- early morning joint stiffness > 30mins
What is the first line treatment of RA?
What is its mechanism of action?
methotrexate
- blocks dihydrofolate reductase enzymes
- prevents DHF > THF
- inhibits eNOS
- stops O2 binding to nitric oxide
- makes T cells more sensitive to apoptosis + decreased proliferation
What is the autoantibody involved in RA?
Rheumatoid factor
Fc portion of IgG
