autoimmune diseases
DESCRIPTION
AUTOIMMUNE DISEASES. DR IDA DZIFA KUWORNOO PHYSICIAN SPECIALIST KBTH. Greek word ‘auto’ meaning self. Due to failure of an organism to recognize its own constituent parts as self leading to an immune response against its own cells and tissues. - PowerPoint PPT PresentationTRANSCRIPT
AUTOIMMUNE DISEASES
DR IDA DZIFA KUWORNOO
PHYSICIAN SPECIALIST
KBTH
• Greek word ‘auto’ meaning self.
• Due to failure of an organism to recognize its own constituent parts as self leading to an immune response against its own cells and tissues.
• Body’s own immune system begins to attack normal tissues cells and organs within the body.
Potential Roles of B Cells in the Immunopathogenesis of RA
• Secretion of proinflammatory
cytokines
• Antigen presentation
• T-cell activation
• Autoantibody productionand self-perpetuation
(Dörner & Burmester, 2003; Edwards et al, 1999; Gause & Berek, 2001; Shaw et al, 2003; Takemura et al, 2001; Zhang & Bridges, 1986) Cartilage lossCartilage loss
IL-6
B cell
T cell
Macrophage
Dendritic cell
IL-10TNF-
TNF-IL-10
RF
Fix Fix complementcomplement
Inflamed Inflamed synoviasynovia
Inflammatory Inflammatory damagedamage
TNF-
B cell
IL-6
B cell
Plasma cell
RF RF
RF
RF
IL-1
Predisposing factors
• Genetics eg.HLADR2-SLE and M. Sclerosis
• HLADR3 SLE, Sjogrens, Myasthenia ,DM type 1
• HLADR4 R. Arthritis, Pemphigus vulgaris
• Environmental
• Sex :They tend to have female preponderance 75%.
• Usually pubertal or childbearing age group
• Hormonal
• Infections :Bacterial or viral e.g. Klebsiella pneumoniae, Chlamydia, Coxsackie virus B.
• Parasitic infections may be protective
• Drugs
• Toxins ,pesticides.
Classification • Local eg Diabetes mellitus type 1,Graves
disease, Addisons disease
• Systemic eg. SLE, Rheumatoid arthritis, polymyositis etc
• GIT:e.g Crohns ,PBC,Autoimmune hepatitis• ENDOCRINE:e.g Type 1 diabetes,Graves
disease,Hashimotos thyroiditis• SKIN e.g.pemphigus vulgaris• NERVOUS SYSTEM e.g.multiple sclerosis,CIDP• HAEMATOLOGIC e.g.autoimmune hemolytic
anaemias,pernicious anaemia• RESPIRATORY e.g.COPD ,sarcoidosis
Symptoms and signs
• Malaise • Fatigue • Rashes • Hair loss• Febrile illness • Recurrent miscarriages • Visual impairment• Joint swellings or pain
• Memory loss
• Limb weakness
• Strokes
DIAGNOSIS
• Accurate history of the illness
• Physical examination
• High index of suspicion
LABORATORY TESTS
• Varied probable depends on system involved.
• Blood counts ,kidney function tests etc
Serological assays for diagnosis, expensive
• MRI’S
• Biopsies for local involvement
Treatment Non medical
• Multidisciplinary
• Counselors
• Physiotherapists
• Occupational therapists
Treatment
• Non immune therapy e.g. hormone replacement in thyroid disease, type 1 diabetes
• Immune modulatory drugs e.g. Steroids, TNF inhibitors etc.
• Anti inflammatory e.g. NSAIDS
• Palliative
• Together fourth largest cause of death among women.
• Affects more people than heart disease in the USA
• Poorly understood poorly recognised
• Need for more awareness