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17 Cards in this Set
- Front
- Back
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What substrate is used for almost all ANA assays?
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Hep-2 (human tumor cell line) hepatocytes
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What % of normal pts w/ no CTD have a titer <1:160?
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5%
15% (>55 y/o) |
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Pattern of Immunofluorescence and Disease assoc:
1. Centromere 2. Peripheral (RIM): ds DNA 3. Nucleolar: ribosomal RNA processing 4. Speckled: ribonucleoproteins |
1. CREST
2. SLE 3. Systemic Sclerosis 4. MCTD |
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What abs can be used to track dz activity in SLE? Wegeners?
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dsDNA for SLE (esp w/ falling complement levels)
C-ANCA for Wegener's |
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Name specific Ab assoc with Lupus
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aAb to Sm and ds DNA
dsDNA correlates to SLE disease, high levels indicate increased risk of lupus nephritis Can confirm results with a second assay such as Farr radioimmunoassay and/or Crithidiae luciliae IIF assay ----------- Also, Anti-Ro and anti-La (which react to hYRNP) are seen |
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Abs assoc with dermatomyopathies
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Anti-Jo-a which is directed against aminoacyltransfer RNA synthetases (correlated w/ increased risk of arthritis, raynaud's and interstitial lung dz)
Anti-Mi2 (esp DM w/ skin involvement) SRP -- risk for fulminant DM/PM w/ cardiac involvement and high mortality rate |
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Name symptoms called "anti-synthetase syndrome"
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Arthritis
Raynaud's phenomenon Interstitial lung disease Anti-Jo-1 (histidyl tRNA synthetase) |
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Ab assoc with Systemic Scleroderma and Morphea
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Anti-centromere Ab (CREST Syndrome)
DNA topoisomerase I (anti-Scl 70) seen in severe SSC may also see: fibrillin-1, histone, and ssDNA (in 30-50% of patients with localized scleroderma) |
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aAb review:
1. SLE 2. Dermatomyositis 3. Systemic sclerosis 4. CREST 5. Wegener's |
1. anti dsDNA and Sm
2. Mi-2 (skin); Jo-1 (antisynthetase syndrome) 3. Topoisomerase-1 (Scl-70) 4. Centromere 5. C-ANCA (anti-proteinase-3) |
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% of hydralazine SLE have skin findings? % of procainamide SLE have skin findings?
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25%
5% |
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What is a serologic marker of drug induced SLE? SCLE?
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Antihistone Ab (SLE)
Anti-Ro Ab (SCLE) |
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Definition of Sensitivity, Specitivity, PPV, NPV?
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Sensitivity: TP/ (TP+FN)
Specifivity: TN / (TN + FP) PPV: TP / (TP+FP) NPV: TN / (TN+FN) |
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Can Embrel cause a lupus like reaction?
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Yes -- with positive anti-dsDNA autoAb and ANA
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Can Infliximab cause a lupus like reaction?
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Yes, with ANA and anti-dsDNA Ab
-- higher rate of aAb formation, but lower SLE manifestation than Embrel |
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Name the Ab associated with SLE like drug reactions
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Anti-histone
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Name the drugs that can cause SLE like drug reactions
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procainamide
hydralazine -- does not cause SCLE like reaction INH chlorpromazine phenytoin methyldopa minocycline |
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Name the drugs that can cause SCLE like drug reactions and what is the associated aAb?
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Anti-Ro aAb
Drugs: HCTZ Diltiazem Griseofulvin Terbinafine NSAIDs Anti-histamines |
