autoimmune diseases

RA, SLE, Sjogren's, Scleroderma

describe the antibodies RA produces

IgM / IgG antibodies are directed against Fc portion of IgG

what happens in RA

immune complexes are formed

inflammatory response is generated

what kind of hypersensitivity response is generated in RA

type III hypersensitivity

what does an RA diagnosis require

radiologic, clinical, and laboratory findings

RA lab findings

• high titer of rhematoid factor (RF)

• low titers of complement

• positive anti-cyclic citrullinated peptide (anti-CCP)

what is the screening test for RA

RF rheumatoid factor assay `

describe RF assay

• patient serum added to reagent composed of particulate carrier attached to IgG

• run positive and negative controls

what is seen in a positive RF assay

visible agglutination

what does RF assay detect

serum IgG

what can the particulate carrier in RF be

latex or RBC

what is the confirmatoy test of RA

anti-CCP

anti-CCP

cyclic citrullinated peptide assay

what is anti-CCP used to confirm

positive RF assays

what does anti-CCP have

high sensitivity and specificity

what kind of technique is anti-CCP

ELISA

what does anti-CCP allow for

earlier diagnosis and earlier treatment

• may reduce joint erosion and deformity

what are SLE, Sjogren’s Syndrome, Scleroderma, RA, etc?

autoimmune diseases

what are the tests for ANA

• ELISA

• IIF

what is used to screen for ANA and why

ELISA

• easier and less costly to perform and interpret than IIF

process of IIF for ANAs

• add dilutions of patient serum to tissue nuclei of human epithelial cells affixed to a slide

• wash and add fluorescent AHG

• read pattern under fluorescent microscope

HEp2 cells

human epithelial cells

what should be reported for ANA microscopy

titer and pattern

what occurs in multiple sclerosis (MS)

autoantibodies to myelin sheath of nerves or myelin basic protein

Multiple sclerosis lab findings

• oligoclonal IgG bands in CSF but not in serum

• usually IgG

what indicates CNS production for Multiple Sclerosis Lab Findings?

oligoclonal IgG bands in CSF but NOT in serum

multiple sclerosis has an autoantibody against :

myelins heath of nerves or Myelin Basic Protein

Rheumatoid Arthritis has an autoantibody against :

IgG (Fc) - 19s anti-IgM autoantibody known as Rheumatoid Factor

Sjogren’s Syndrome has an autoantibody against :

salivary duct/ tear duct