Autoimmune Diseases

AUTOIMMUNE DISEASES R. HUGO MARTÍNEZ LOZANO, M.D. Sep-13, 2006

LEARNING OBJECTIVES K & U: - GENERAL FEATURES - IMMUNOLOGIC TOLERANCE - MECHANISMS OF AUTOIMMUNITY - THE MOST IMPORTANT CHARCT. OF: - LES - RA - SS - SYSTEMIC SCLEROSIS Ref: 223-239 & lecture’s information 

GENERAL FEATURES  

FRECUENCY: DISEASE VS NORMALITY

CRITERIA FOR DX OF AUTOIMMUNE DISEASES  



AUTOIMMUNE REACTION NOT SECONDARY TO TISSUE DAMAGE NO OTHER CAUSE

IMMUNOLOGIC TOLERANCE  

CENTRAL: DEATH OF SELF-R LYMPH PERIPHERAL: - ANERGY: NO COSTIMULATORS B7 INHIBITORY R CTLA-4 - SUPPRESSION BY REGULATORY T - CLONAL DEL. BY ACTIVATION OF INDUCED CELL DEATH (FASL-FAS)

MECHANISMS OF AUTOIMMUNE DISEASES

ROLE OF INFECTIONS

ROLE OF INFECTIONS

C. EPITOPE EXPOSITION & SPREAD.

SLE: GENERAL FEATURES   

INCIDENCE: 1:700 SEX: 9:1 ETHNIC GROUP

CLINICAL CRITERIA: (TABLE 6-8. p. 228)         

MALAR RASH DISCOIDE RASH PHOTOSENSITIVITY ORAL ULCERS ARTHRITIS SEROSITIS RENAL INVOLVEMENT ANA ETC.

ANA      

GENERIC ANTI-DOBLE-STRANDED DNA ANTI-SMITH (Sm) ANTIHISTONE (DRUG-INDUCED LE) SS-A & B (RNP) ANTICENTROMERE (CREST)

RISK FACTORS   

GENETIC ENVIRONMENTAL IMMUNOLOGIC

PATHOGENESIS: VASCULITIS (PHASES)

PENPHYGUS VULGARIS

SKIN: ANTI-B.M. INJURY

SKIN RASH

VASCULAR INJURY: GN

i o n s o f S y s t e m i LES: c ULTRASTRUCTURE. L u p u s E r

LIBMAN-SACHS ENDOCARDITIS

SUBCUTANEOUS LE  

DR3 SS-A

DRUG-INDUCED LE   

HYDALAZINE ISONIAZID OTHER

R.A.

SEVERE INTESTINAL VASCULITIS

SJÖGREN SYNDROME (SS)

S.S. 

DEFINITION: XEROSTOMIA K-C SICCA

S.S. 

FORMS: PRIMARY (SICCA SYNDROME) SECONDARY

RISK FACTORS: HLA: B8, DR3, DRW52, ETC. EBV, HCV, HTLV-1 MORPHOLOGY…

SYSTEMIC SCLEROSIS (SCLERODEMIA) DEFINITION: ABNORMAL FIBROUS TISSUE IN SKIN & MULTIPLE ORGANS  TYPES:- DIFFUSSE SD - LIMITED SD - CREST SYNDROME DX: - DNA TOPOISOMERASE-I (ANTI-SCL 70) - ANTICENTROMERE 

SD: MORPHOLOGY

SEVERE REYNAUD + NECROSIS

LESION?

CALCIONOSIS

SUBCUTANEOUS CALCINOSIS

ESOPHAGEAL INVOLVEMENT

DX?

QUESTIONS?