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what is the most common test used to HELP in the diagnosis of SLE?
ANA test (antinuclear antibodies)
autoimmune diseases that involve multiple organ systems are known as ___________ immune diseases or disorders
systemic
systemic immune diseases:
patients develop immune-complex deposition that leads to chronic __________ in multiple organs
-preferentially affects capillary beds
inflammation
what does SLE stand for?
systemic lupus erythematosus
what parts of the body does SLE affect?
-skin
-joints
-serous membranes
-renal system
-hematologic system
-neurologic system
SLE is clinically seen in what three animals?
-dogs
-cats
-horses
SLE is which hypersensitivity reaction classification type?
type III
pathogenesis of SLE:
_________ cells from affected patients are not cleared normally through phagocytosis
apoptotic
SLE:
________ light exposure of skin leads to accumulation of apoptotic cells and ultimate auto-antibody development against the skin
UV
what are the three laboratory tests that are supportive of diagnosing SLE?
-LE preps
-positive ANA antibody tests
-biopsy results
when conducting an ANA test, a positive result means the patient probably has SLE. we say only probably even though 97-100% of SLE patients test positive. why?
16-20% of control patients test positive for ANA too
what is an LE prep in simplest terms?
seeing if the phagocytes have consumed material
treatment for SLE works in which of the following:
a) horses
b) dogs
b) dogs
treatment for SLE
-steroids
-immunosuppressive therapy
what does DLE stand for?
discoid lupus erythematosus
DLE is a mild variant of ________ where only facial/skin lesions are seen
SLE
ANA/LE tests will be [positive/negative] in DLE
negative
treatment for DLE
oral steroids or topical steroids
why are ANA and LE tests negative in Discoid Lupus if they are positive in SLE?
there is not a systemic immune issue; the immune complexes are only depositing in the localized basement membrane
how do you differentiate SLE from DLE?
SLE is going to be systemic (affects kidney, joints, heart, etc.) while DLE affects the basal layer of the skin
in the context of autoimmune polyarthritis, which is more common in domestic animals?
a) erosive
b) non-erosive
b) non-erosive
this disease causes marked joint pathology and secondary systemic signs
*deposition of immunoglobulins or immune complexes within joints
autoimmune polyarthritis
autoimmune polyarthritis is separated into what two groups?
erosive polyarthritis (Rheumatoid arthritis) and non-erosive polyarthritis
-most important variant in humans
-characterized by erosion of joint cartilage, deformities, bony ankyloses, and soft tissue swelling
a) erosive polyarthritis
b) non-erosive polyarthritis
a) erosive polyarthritis
-most important variant in domestic species
-no joint cartilage erosion
-lesion confined to joint capsule and synovia
a) erosive polyarthritis
b) non-erosive polyarthritis
b) non-erosive polyarthritis
how do you diagnose Rheumatoid arthritis (erosive)
-presence of characteristic findings
-presence of RF antibodies
-negative ANA test to rule out SLE
what are RF antibodies?
an antibody against the Fc portion of IgG
what is Rheumatoid factor (RF)
antibody against IgG
treatment for Rheumatoid arthritis
-analgesics
-steroids
-monoclonal antibodies to TNF, CD4, IL-2
-joint fusion
what are the 3 types of Non-erosive autoimmune polyarthritis?
1. associated with SLE
2. associated with Myositis
3. idiopathic (Immune Mediated Poly-Arthritis - IMPA)
what is the most common type of non-erosive polyarthritis?
idiopathic polyarthrities (I.e. IMPA)
what are the 4 sub-types of Idiopathic IMPA?
1. truly idiopathic - no other diseases
2. associated w/ infectious lesion outside joints
3. associated with GI disease (overlaps with 2)
4. associated with a neoplasia remote from joints
what symptom would you not see in idiopathic IMPA:
a) stiffness
b) lameness
c) positive ANA
d) hypertrophy of mononuclear infiltrate
c) positive ANA
*if so, then you probably have PA from SLE
symptoms of idiopathic polyarthritis
-fever, lethargy, anorexia, lameness, muscle atrophy
-stiffness after rest
-stifle, elbow, and carpus most commonly affect
-no joint erosion
-significant soft tissue swelling & joint effusion
the prognosis for IMPA is generally:
a) good
b) bad
a) good
Rheumatoid arthritis is erosive or non-erosive?
erosive
how would you diagnose idiopathic polyarthritis?
-characteristic signs // history
-negative ANA and RF
-sterile joint fluid
-synovial biopsies show hypertrophy with mononuclear infiltrate
treatment of idiopathic polyarthritis
steroids
what disease is this?
-clinical syndrome of dermatitis & myositis
-humans, Collies, and Shelties
-normal at birth..develop skin lesions at 7-11 weeks and develop myositis at 12-23 weeks
-skin lesions are seen first
Dermatomyositis
Dermatomyositis:
disease onset and progression characterized by rise in circulating immune complexes and serum _____
IgG
treatment of Dermatomyositis
-steroids
-vitamin E
-pentoxy
what disease is this?
-affects beagles <2 years of age
-signs include episodic fever and cervical pain
-poor prognosis
-histologic changes include inflammatory cell infiltrates involving medium and small-sized arteries
-ultimately leads to fibrosis
-can progress to amyloidosis
Canine Juvenile Polyarteritis