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43 Cards in this Set
- Front
- Back
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what kinds of cells are autoimmunity associated with?
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"stress proteins" of human or bacterial cells
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what is another name for SLE?
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the red wolf
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etiology of SLE?
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failure of self-tolerance
high levels of ab to RNA and DNA |
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what are diagnostic criteria for lupus?
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ANA almost always positive
ab to ds-DNA and smith ag (dogs of lupus patients are more likely to have ANA elevations) |
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what are some environmental, drug and dietary factors in SLE?
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alfalfa
hydralazine/procainamide d-penicillamine isoniazid steroids UV exposure |
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what is SLE incidence?
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10:1 women in childbearing years vs. men
exacerbations during menses and pregnancy (high E and P) 1:2500 women worldwide 1:700 women in childbearing years 1:245 African American women |
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what is the morphology of the L.E. cell of SLE?
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any phagocyte that contains a coagulated nucleus of an injured cell
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*what is the morphology of vasculitis in SLE?
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occurring most often in skin, muscle and spleen. fibrinoid necrosis in vessel walls (onionskin lesions)
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what are different types of lupus nephritis?
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mesangial glomerulonephritis
focal proliferative glomerulonephritis diffuse proliferative glomerulonephritis membranous glomerulonephritis (kidney and vascular of nephron are viserious) |
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what skin lesions may be seen in SLE? where?
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butterfly rash. face and trunk
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what is lupus morphology in joints?
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non-erosive synovitis w/o deformity (doesn't erode cartilage, unlike rhum. arthritis)
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what is lupus morphology in CNS?
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occlusion of small vessels by intimal proliferation
arteritis ab to synaptic membrane proteins |
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what is lupus morphology in heart?
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pericarditis, mb fibrinous exudate
endocarditis (libman-sachs) warty deposits on either side of valves atherosclerosis |
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what is lupus morphology in lungs?
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pleuritis
effusion interstitial fibrosis |
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where does lupus morphology take place?
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lungs
heart CNS joints lymphadenopathy splenomegaly skin lesions |
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what is lupoid hepatitis?
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vasculitis of portal tracts with lymphocytic infiltrates
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what 4 of 11 criteria may be present in SLE diagnosis? all at once?
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malar rash
photosensitivity oral ulcers arthritis serositis immunologic disorder antinuclear ab renal disorder neurological disorder no |
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*what is a protean?
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highly variable, unpredictable course with exacerbations and remissions. most patients look healthy but are very sick.
FUO, proteinuria, RBC casts, hematuria typical rash, arthritis, pericarditis, pleurisy anemia psychosis, seizures, depression discoid lupus is variant (90% w/o systemic sx) |
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what is discoid lupus? characterization?
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symmetric atrophic hypopigmented plaques with hyperpigmented and minimally scaly border.
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what body parts are involved in SLE?
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spleen, liver, CNS, skin, kidney, veins, heart, lymph nodes, (arthritis)
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what is the allopathic tx of SLE?
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steroids
antimalarials NSAIDS |
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what is the naturopathic tx of SLE?
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*gut ecology (treat intestinal hyperpermeability)
liver constitutional and emotional work, etc. |
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what is sjogren syndrome?
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combination of keratoconjunctivitis sicca, xerostomia and arthritis.
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what is sicca syndrome?
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dry mouth and eyes when primary and secondary sjogren when associated with RA, SLE, scleroderma, thyroiditis or mixed CT disease.
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what is the epidemiology of sjogren syndrome?
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middle aged women, 2M in U.S.
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what is the etiology of sjogren syndrom?
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autoimmune exocrinopathy
T cells infiltrate and destroy the glands *anti-SSA, anti-SSB are specific ANA |
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what is the clinical significance of sjogren syndrome?
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*dry mouth and eyes
may have shortness of breath 40x increased risk of lymphoma 20% w/ MS-like CNS syndrome 40% w/ nephritis (like SLE) |
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what is scleroderma (progressive systemic sclerosis)?
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a family of slowly progressive diseases with *excessive fibrosis throughout the body
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what is the etiology of scleroderma?
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unclear, but related to fibroblasts making excess collagen which may be triggered by IL-1 and environmental triggers (these patients have ANA, especially anti-endothelial ab)
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what is PSS morphology?
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small vessel intimal proliferation/concentric fibrosis= "onionskinning"
raynaud phenomenon (discoloration of fingers) sclerodactyly (tight, thick skin esp on hands and fingers) "rubber hose esophagus" |
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in scleroderma, what is the CREST syndrome?
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milder variant
C=calcinosis R=raynaud syndrome E=esophageal dysfunction S=sclerodactyly T=telangiectasia |
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what is morphia?
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segmental atrophic and slightly fibrotic mottled hyperpigmented and hypopigmented plaques
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what is polymyositis-dermatomyositis?
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polymyositis is an inflammatory disease that damages skeletal muscle. dermatomyositis is similar but w/ skin involvement
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what is the etiology of polymyositis-dermatomyositis?
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probably autoimmune. may occur with other collagen-vascular disease.
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what is the morphology of polymyositis-dermatomyositis?
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PM affects proximal muscles of the extremities and spares extra-ocular muscles. DM causes butterfly rash, heliotrope eyelids, periorbital edema and Grotton lesions, and may also have soft tissue calcification.
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what is the clinical significance of PM-DM?
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weakness gettingup from chair or climbing steps
fine motor skills may be affected later in disease high risk for lung, ovary, and stomach cancers **diagnosis by elevated CK and muscle biopsy |
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what is mixed CT disease?
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undifferentiated CT disease.
features of lupus, polymositis and scleroderma. patients have severe raynaud phenomenon and joint pain, mild mysitis and swollen fingers. specific ANA is anti-U1 RNP |
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what is fibromyalgia?
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syndrome of tender points, generalized muscle pain, fatigue, sleep disorders, head pain, depression and digestive sx w/ no abnormal labwork or morphology
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what is the etiology of fibromyalgia?
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localized metabolic shutdown dt phosphate or uric acid build-up
mitochondrial dysfunction leads to an ATP deficient state aluminum excess may inhibit glycolysis and ox-phos (kreb cycle factors such as malic acid may be beneficial) low serotonic levels may be involved substance P may be increased |
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what are 2 possible risk factors for fibromyalgia?
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neck injuries and antioxidant status
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what is fibromyalgia associated with?
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restless leg syndrome
autonomic dysfunction lack of restorative sleep and chronic widespread pain |
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what is the allopathic tx for fibromyalgia?
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amytryptiline, trazadone, diphenhydramine, cyclobenzaprine, alprazolam, carisoprodol
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what is the naturopathic tx for fibromyalgia?
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kreb cycle nutrient supplementations, homeopathy, acupuncture, body work, microcurrent, neurofeedback, alpha stim, food allergy elimination, detoxification, tx of dysbiosis and heavy metal burdens, etc.
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