IMMUNO PART 8 and 9 and 10

AUTOIMMUNITY

production of antibodies against the tissues of your own body

LUPUS ERYTHEMATOSUS

collection of autoimmune diseases, in which the human immune system becomes hyperactive and attacks normal, healthy tissues.

CLASSIFICATION for lupus

• Discoid Lupus Erythematosus • Drug-induced Lupus Erythematosus • Neonatal Lupus Erythematosus • Systemic Lupus Erythematosus(SLE)

SLE (Systemic Lupus Erythematosus)

an autoimmune disorder , non contagious, chronic, progressive inflammatory disease of the connective tissue • cause is UNKNOWN

Signs and symptoms of SLE

Arthritis (initial manifestation) to arthralgia • Weakness, fever, fatigue, weight loss • Photosensitivity from the sun • Butterfly rash / malar rash •Skin lesions

DIAGNOSTIC CRITERIA for lupus

Serositis - Pleuritis or pericarditis or peritonitis •

Oral ulcers •

Arthritis •

Photosensitivity

Blood •

Renal disorder •

Antinuclear antibody •

Immunologic disorder •

Neurologic disorder

• Malar rash • Discoid rash

The ANA test / Anti nuclear antibodies/ANA or ANF

measures the pattern and amount of autoantibody which can attack the body's tissues as if they were foreign material.

Kawasaki Disease

a.k.a. Mucocutaneous Lymph Node Syndrome It is a rare childhood illness that affects the blood vessels and it causes inflammation in the walls of medium-size arteries throughout the body

STAGES OF KAWASAKI DISEASE

Stage 1 - Acute Febrile Phase (First 10 days)

Stage 2 - Subacute Phase (Day 11 to 25)

Stage 3 - Convalescent Phase (Day 40 to 70)

Stage 1 of kawasaki disease

• Fever - 40-degree Celsius for 5 days or more • Oropharyngeal erythema and red dry lips • Erythema and edema of hands and feet, rash, and enlargement of cervical lymph nodes

Stage 2 of kawasaki disease

• Acute symptoms of stage 1 subside as temperature returns to normal but still the client remains irritable and anorexic • Dry, cracked lips with fissures • Desquamation of toes and fingers • Coronary thrombus, aneurysm, myocardial infarction and heart failure • Thrombocytosis peaks at 2 weeks

Stage 3 of kawasaki disease

• Client appears to well • Transverse grooves of fingers and toenails • Coronary thrombosis, aneurysm may occur

definitive sign of kawasaki disease

Vasculitis

prevent coronary artery disease and to relieve symptoms.

The principal goal of treatment for Kawasaki Disease is to?

Rheumatic Disease common sites

• Skeletal muscles, • bones, • cartilage, • ligaments, • tendons, and • joints

Rheumatoid Arthritis

is a systemic inflammatory disease that affects 0.3% to 1.5% of the population, with women affected two to three times more frequently than men.

Peak: 40-60y.o. • Onset: 30-50y.o

• Pannus

-proliferation of newly formed synovial tissue infiltrated with inflammatory cells

STAGES OF RHEUMATOID ARTHRITIS

Stage 1 - this is the early stage of RA • Stage 2 - moderate stage RA • Stage 3 - severe RA • Stage 4 - the end-stage RA

symptom control for RA

• Regulating activity by pacing, establishing priorities, and setting realistic goals • long-term adherence to the prescribed treatment modalities • Proper posture, positioning,body mechanics, and the use of supportive shoes

Disease modifying antirheumatic drugs (DMARDs) include

gold salts, hydroxychloroquine, sulfasalazine, methotrexate, and azathioprine

NSAIDS and ASA for RA

celecoxib, rofecoxib, and valdecoxib

Methotrexate

- most potent: effect can be seen in 1 month- interfere with purine metabolism, leading to the release of adenosine, a potent anti inflammatory compound

Antirheumatic drugs

leflunomide, etanercept, infliximab, and adalimumab

Leflunomide

Pyrimidine synthesis inhibitor that blocks the expansion of T cells

Infliximab

etanercept, and adalimumab are biologic response-modifying agents that block tumor necrosis factor

Surgical Treatment for RA

Synovectomy • Tenosynovectomy • Arthroplasty • Arthrodesis

HODGKIN'S DISEASE

is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes ▪ is characterized by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease

HODGKINS

(Reed-Sternberg cell)

•NON-HODGKIN'S

(b cells, t cells or nk cells)

Signs and Symptoms of hodgkins disease

Enlarged lymph nodes in the neck, underarm, groin, or stomach •Fever, night sweats, known reason weight loss for no • itchy skin, and feeling very tired. NHD (+symptoms) Skin rash, chest pain, abdomen or bones for unknown reason (systemic symptoms)

Treatment for HD

chemotherapy, radiation therapy, and surgery.

Treatment for NHD

chemotherapy, radiation therapy, and surgery.

+ immunotherapy, targeted therapy, plasmapheresis, antibiotic therapy, surgery, stem cell transplant

MULTIPLE MYELOMA

A malignant disease of the most mature form of B lymphocyte, the plasma cell. • Proliferation of plasma cell from BM into the hard bone tissue causing erosion of the bone • Unknown cause

Plasmacytomas

malignant plasma cell tumor

Classic Triad

Plasmacytosis •Lytic bone lesion (plasmacytomas) •M. protein or Bence Jones Protein

(+) Bence Jones

protein in the urine : urine

(+) M protein

serum protein electrophoresis

Pamidronate (Aredia)

-Zoledronic Acid (Zometa

•Meds shown to strengthen bone, controlling bone pain and bone fracture: by diminishing osteoclast activating factor (biphosphonates

Thalidomide (Thalomid)

a sedative having antimyeloma effect.

S/E: fatigue, dizziness, constipation, rash and peripheral neuropathy