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45 Cards in this Set
- Front
- Back
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What is the prototype autoimmune disease?
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Systemic lupus erythematosus
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What are the 5 multisystemic autoimmune diseases?
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SRSSG
-SLE -Rheumatoid arthritis -Sjogren's syndrome -Scleroderma -Goodpasture's syndrome |
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What are 10 organ specific autoimmune diseases? (acronym)
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AMPPAIPAIP
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What do the first three letters of AMPPAIPAIP stand for?
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-Autoimmune thyroiditis
-Myasthenia gravis -Pernicious anemia |
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What does PAIPAIP stand for?
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Polymyositis
Addison's Insulin dependent diabetes Primary biliary cirrhosis Autoimmune hemolytic anemia Idiopathic thrombocytopenic purpura Penphigus vulgaris |
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In what patients is lupus more common?
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Women
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In what tissues does injury occur in SLE?
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-skin
-joints -kidneys -serosal membranes |
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What test is false positive in lupus?
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VDRL for syphilis
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What two types of rash are very specific for SLE?
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-Malar rash
-Discoid rash |
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What 3 ANA's are relatively diagnostic for SLE?
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-Anti-dsDNA
-Anti-Sm -Anti-histone |
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What are high titers of Anti-dsDNA associated with?
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Active glomerulonephritis
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What do rises and falls in antibody titers of SLE correlate with?
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Disease activity
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What type of lupus is associated with Anti-histone antibodies?
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Drug-induced le
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What exacerbates the classic malar rash in lupus? What type of lupus is this called?
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Sunlight makes it worse;
Acute cutaneous lupus |
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What does a histologic exam of skin show in acute cutaneous le?
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Interface dermatitis
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What is the pathologic mechanism of acute cutaneous LE?
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Deposition of IgG and C3 along the basement membrane
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What is the characteristic finding in discoid LE?
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Skin plaques with elevated erythematous border
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What is the good thing about discoid LE?
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Only 5-10% of patients develop systemic LE, and only after several years
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What is the ANA pattern of discoid LE like?
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-35% have a pos ANA
-Rarely is anti-dsDNA present |
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What percentage of SLE patients have hematologic involvement?
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100%!!!
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What are 4 antibodies present in SLE patients?
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-Anti-RBCs
-Antiplatelets -Antilymphocytes -Antiphospholipid |
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What are two results of having an Anti-phospholipid antibody?
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-False positive RPR test (VDRL)
-False prolonged PTT |
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Why is the Anti-phospholipid antibody in SLE called lupus anticoagulant?
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Because it actually causes a hypercoagulable state; it's a misnomer.
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What percent of SLE patients have renal involvement?
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50%
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What does the renal involvement in an SLE patient tell?
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The prognosis or progression of disease in the patient
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What is the renal involvement in SLE?
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Glomerulonephritis (one of 5 types)
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What does glomerulonephritis result in?
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Hematuria and proteinuria
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What is the mild form of glomerulonephritis?
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Mesangial
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What are the levels of glomerulonephritis form mildest to worst?
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1. Mesangial
2. Focal proliferative 3. Diffuse proliferative 4. Membranous 5. Diffuse thickening of the BM |
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What abnormal findings on urinalysis result from the hematuria and proteinuria?
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Cellular casts, RBC casts, and way casts.
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Which is the most serious of renal lesions in SLE?
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Diffuse proliferative glomerular lesions
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What is drug-induced LE?
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A type of "lupus" that is diagnosed by a pos ANA in patients on certain meds
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What are 4 meds that cause drug-induced LE?
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-Hydralazzine
-Procainamide -d-Penicillamine -Isoniazide |
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Do patients with drug-induced LE have symptoms of SLE?
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no
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What is the characteristic ANA finding in drug-induced LE?
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Anti-histone antibodies
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What is Felty's syndrome triad?
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-Rheumatoid arthritis
-Splenomegaly -Neutropenia (with an accompanying lymphocytosis) |
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What is Sjogren's syndrome?
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Immunologic destruction of the lacrimal and salivary glands
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What is it called when Sjogren's syndrome occurs by itself?
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Sicca syndrome
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Who are most patients that get Sjogren's syndrome?
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Females between 40-50
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What are the characteristic antibodies found in Sjogren's syndrome?
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Anti-SS-A (anti-ro)
Anti-SS-B (anti-la) |
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What is the morphologic finding of Sjogren's syndrome?
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Periductal and perivascular lymphocytic infiltration in salivary glands
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What is a common finding in Sjogren's syndrome patients with high titer Anti-SS-A?
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Involvement of the kidneys, lungs, skin, and CNS
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Where are the renal lesions (if present) in SS patients?
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In the TUBULES
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Are there only T-cell mediated mechanisms in SS?
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No; there is also enlargement of lymph nodes due to polyclonal Bcell activation
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What is the result of the B-cell activation in Sjogren's syndrome?
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A 40X greater risk of developing lymphoma
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