Organ Specific Autoimmune Diseases (Exam 3)

Grave's Disease affects the ______.

thyroid

This causes ______thyroidism (hypo/hyper).

hyperthyroidism

Grave's disease has a strong genetic association with the ______ allele.

HLA-DR3

What are some environmental triggers of Grave's Disease?

- Medications

- Smoking

- Pregnancy

Which sex is more susceptible to Grave's Disease?

Females

Grave's Disease S/Sx

- Goiter (enlarged thyroid)

- Bulging eyes

Grave's Disease is ______ cell mediated.

T/B

The B cells in this disease produce ______.

autoantibodies

What are the autoantibodies towards?

- TSH receptor (TSI autoAb)

- Thyroglobulin (Tg)

- TPO

In Grave's Disease, epithelial cells of the thyroid present ______ to activated T cells via HLA-DR3.

self antigen

Mutations in the ______ could have a potential role in Grave's Disease.

TSH receptor

What is the treatment for Grave's Disease?

Radioactive iodine

Radioactive iodine destroys the ______ portions of the thyroid.

overactive

In the lab, Grave's Disease will show decreased/no ______ and elevated ______.

TSH, free T4

There will also be the presence of ______ autoantibody in 99% of patients.

TSH receptor

Samples with Grave's Disease can be analyzed via ______.

chemiluminescent immunoassay

Hashimoto's Disease affects the ______.

thyroid too

It causes ______thyroidism (hyp/hyper).

hypothyroidism

Hashimoto's Disease has some genetic association with ______.

HLA-DR

High ______ intake can trigger Hashimoto's Disease.

iodine

This causes heavy iodinated ______.

thyroglobulin

Hashimoto's Disease is the most common autoimmune disease, specifically in ______ (men/women).

women

S/Sx of Hashimoto's Disease

- Goiter

- Puffy face

- Dry skin

- Weight gain

- Cold all the time

Hashimoto's Disease is ______ cell mediated.

T/B too

In Hashimoto's Disease, epithelial cells of the thyroid present ______ to activated T cells.

self antigen

With Hashimoto's Disease, B cells will produce ______ and ______ autoantibodies.

anti-TPO, anti-Tg

Daily oral ______ can be used for Hashimoto's Disease treatment

thyroid hormone

Thyroid cell death can occur via activation of ______ by anti-TPO and anti-Tg autoantibodies, leading to necrosis.

complement

Thyroid cell death can also occur via ______ binding to the cell, leading to apoptosis.

CTL

Binding of ______ can also cause apoptosis of thyroid cells in Hashimoto's Disease.

death receptor : death ligand

In the lab, Hashimoto's Disease will produce normal/elevated ______ and decreased ______.

TSH, free T4 too

Specimens with Hashimoto's Disease are tested via ______.

chemiluminescent immunoassay too

In Type I Diabetes, autoimmune destruction of the ______ occurs.

pancreatic beta cells

Type I Diabetes has a genetic association with ______ and ______.

HLA-DR3/DR5, HLA-DQ

While autoantibodies start the immune reaction in Type I Diabetes, ______ destroy the beta cells.

T cells

______ can occur in a Type I Diabetes patient when >80% of the beta cells are destroyed.

Chronic hyperglycemia

S/Sx of Type I Diabetes show up ______ production of autoantibodies.

years after

What autoantibodies are produce in Type I Diabetes?

- anti-IA-2/2BA

- anti-GAD-65

- anti-insulin

- anti-islet cell

- anti-ZnT8

Clinical ______ and the presence of ______ confirms Type I Diabetes.

glucose/HgbA1C, autoantibodies

Samples are analyzed via ______ using frozen human pancreas or via ______.

IIF, mass spec/ELISA

Celiac Disease affects the villi of the ______.

small intestine

Celiac Disease can be triggered by ingestion  ______.

of gluten

Celiac Disease has a strong genetic association with ______ and ______.

HLA-DQ2, HLA-DQ8

_______ are slightly more susceptible to Celiac Disease (women/men).

Women

S/Sx of Celiac Disease vary by age, but often cause ______.

abdominal pain

In Celiac Disease, the ______ peptide is presented to ______ T cells.

gliadin, CD4

This activated ______ T cells.

CD8

Avoiding ______ is the common treatment for Celiac Disease.

gluten

In the lab, Celiac Disease will show serum ______ antibodies to ______.

IgA, tissue translutaminase (tTG)

Samples wth Celiac Disease is assessed via ______.

ELISA

A biopsy of the small intestines will show increased ______ and ______ destruction.

lymphocytes, villi

______ is needed for diagnosis of Celiac Disease.

HLA typing

Autoimmune Liver Disease includes ______ and ______.

Autoimmune Hepatitis, Primary Biliary Cirrhosis

There is a ______ association with both of these forms of liver disease.

genetic

Autoimmune Hepatitis and Primary Biliary Cirrhosis can affect children and adults, showing very ______ symptoms.

vague

Autoimmune Hepatitis and Primary Biliary Cirrhosis can result in ______ liver disease, which requires a transplant.

end-stage

Autoimmune Hepatitis and Primary Biliary Cirrhosis are ______ mediated.

autoantibody

What autoantibodies are present in these diseases?

- ANA

- ANCA

- SMA

- AMA

______ or ______ are used for detection of these autoantibodies.

IIF, ELISA

Liver ______ and liver serum ______ analysis are needed for these autoimmune liver diseases.

Biopsy, enzyme

______ also needs to be ruled out when diagnosing Autoimmune Hepatitis or Primary Biliary Cirrhosis.

Viral hepatitis

Multiple Sclerosis (MS) causes inflammation and destruction of the ______.

CNS

MS has a strong genetic association with ______.

HLA-DRB1, 1501 haplotype

What environmental factors can trigger MS?

- Reduced exposure to sunlight (Vitamin D deficiency?)

- Cigarette smoking

In MS, plaques composed of ______ form.

T cells/macrophages

These plaques lead to destruction of ______ of axons.

myelin sheaths

Treatment for MS includes medications that block ______ action or ______ adhesion/activation.

cytokine, T cell

On an MRI, MS will show ______ in the white matter of the brain.

plaques

When performing CSF electrophoresis (or isoelectric focusing), ______ bands will be present in an MS patient.

oligoclonal

Myasthenia Gravis affects the ______ junction, causing weakness of skeletal muscle.

neuromuscular

Myasthenia Gravis has some genetic association with ______.

HLA-A1, B7/B8, DR2

Treatment with ______ is often successful for Myasthenia Gravis patients.

anti-cholinesterase

Myasthenia Gravis patients have an autoantibody to their ______ receptors.

acetylcholine

Rarely, a Myasthenia Gravis patient will have an ______ autoantibody.

anti-MuSK

The thymus also plays a role in Myasthenia Gravis, producing ______.

autoreactive T cells

______ assay is used to detect anti-acetylcholine receptor autoantibodies.

Radioimmunoprecipitation (RIPA)

RIPA detects ______ between patient serum and supplied antigen (receptors) with radio-labeled ______.

precipitation, snake venom

______ also used in the lab to diagnose Myasthenia Gravis.

ELISA is

Goodpasture's Syndrome is a result of autoimmune reaction towards antigen in the basement membrane of the ______ and ______.

kidney, alveoli of the lungs

Goodpasture's Syndrome causes vague S/Sx, but ______ and ______ issues are the most common.

kidney, respiratory

Goodpasture's Syndrome has a strong genetic association with ______.

HLA-DRB1-15

Environmental factors that trigger Goodpasture's Syndrome include ...

- Solvent exposure

- Cigarette smoking

In the lab, Goodpasture's Syndrome will show decreased ______.

GFR

It will also cause elevated serum markers of ______, ______, and ______.

kidney function, hematuria, proteinuria + casts

Many patients with Goodpasture's Syndrome will have ______.

Iron Deficiency Anemia

Detection of autoantibodies present in 85% of Goodpasture's Syndrome patients is done via ______.

ELISA too

Examination of ______ can also be performed for autoantibodies and cells.

tissue biopsy

Addison's Disease occurs due to an ______ insufficiency.

adrenal

Patients with Addison's Disease have ______ autoantibodies.

adrenal cortex

______ autoantibody is present in Addison's Disease patients.

21-hydroxylase

The level of ______ enzyme predicts the development of Addison's Disease and correlates with the amount of dysfunction.

cytochrome P450