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30 Cards in this Set
- Front
- Back
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Strongest HLA association with celiac disease
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HLA-DQ2 (95% of patients)
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Characteristic biopsy findings in celiac disease
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blunting of villi with crypt hyperplasia and expansion of lamina propria mononuclear cells
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Cutaneous condition associated with celiac disease
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Dermatitis herpetiformis--pruritic, vesicular/excoriated lesions on the extensor surfaces of the extremeties, trunk, buttocks, scalp, neck
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4 conditions associated with celiac disease
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Dermatitis herpetiformis
IgA deficiency Autoimmune disorders Malignant disease |
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What type of Th cells/cytokines are associated with celiac disease?
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Th1 cells, producing IFN-gamma and TNF-alpha, which then act on intestinal macrophages to produce proinflammatory il-1beta and TNF-alpha
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What is the most common cause of vitamin B12 deficiency?
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Autoimmune gastritis (pernicious anemia)
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Major immunologic features of autoimmune gastritis?
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Autoantibodies to parietal cell and intinsic factor (major targets are H+ and K+ATPase). CD4+ T-cells mediate the disease
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What age/gender is primarily affected by pernicious anemia?
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Older women
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How do you diagnose pernicious anemia?
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Schilling's test for the detection of vitamin B12 malabsorption.
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Pathophysiology of autoimmune gastritis?
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atrophy of gastric parietal cell (mediated by CD4+T-cells) and loss of intrinsic factor production by zygomatic cells, leading to vitamin B12 malabsorption
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Treatment of autoimmune gastritis
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vitamin b12 injections (lifelong)
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Prognosis of untreated autoimmune gastritis
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Neurologic damage
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Biopsy findings in Crohn's disease
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Transmural granulomatous inflammation of the bowel wall
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What genetic mutation is most strongly associated with Crohn's disease?
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Mutation of NOD2 (20-50% of patients with Crohn's).
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What Th-cell type (and cytokines) are associated with Crohn's disease?
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Th1, IL-12/INF-gamma
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True or false: patients with Crohn's disease mount an inflammatory response to their own bowel flora?
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True.
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What ethnic group is particularly affected by Ulcerative Colitis?
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Ashkenazi Jews
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Biopsy findings in ulcerative colitis?
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Mucosal inflammation and superficial cryptitis.
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What age/gender is typically affected by Type I autoimmune hepatitis?
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women of any age
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Autoantibodies in type I autoimmune hepatitis?
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ANA
ss or ds DNA p-ANCA smooth muscle actin soluble liver antigen |
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What age/gender is typically affected by Type II autoimmune hepatitis?
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Children, women
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5 Conditions associated with type II autoimmune hepatitis?
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Type I DM
Arthritis Autoimmune thyroiditis Sjogren's syndrome Vitiligo |
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What type of autoantibodies is associated with type II autoimmune hepatitis?
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Cytochrome P450
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What age/gender is tyically affected by Type III autoimmune hepatitis?
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Any age (women>men)
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What type of autoantibodies are associated with type III autoimmune hepatitis?
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Anti-liver-kidney-microsomes
Liver-cytosol-antigen +/- soluble liver or pancreas Ag |
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What age/gender is most commonly affected by primary biliary cirrhosis?
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Middle aged women (90% of patients)
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What type of autoantibodies are associated with primary biliary cirrhosis?
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anti-mitochondrial (usually IgG, although IgM or IgA are possible)
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What age/gender is primarily affected by primary sclerosing cholangitis?
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Male predominance (2:1)
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What condition is strongly associated with primary sclerosing cholangitis?
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UC (close to 90% of patients with PSC have UC)
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What are key pathologic findings in primary sclerosing cholangitis?
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Fibrous, obliterative that occurs in a segmental pattern in intrahepatic and extrahepatic bile ducts. CD8 T-cells predominate.
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