Lymphomas and Autoimmune Diseases

Hypersensitivity Type I

antigen producing IgE response

*Immediate reaction

*AB mediated (IgE)

Hypersensitivity Type I Clinical manifestations

• Mild - seasonal allergies, eczema

• Severe - anaphylaxis

• Symptoms - hives, localized edema, throat constriction, wheezing

Hypersensitivity Type II

antibodies attack antigen on surface of the cell to cause lysis through mediation of activated complement fragments

*Immediate reaction

*AB Mediated - IgG

transfusion reaction and hyperacute graph rejection

Hypersensitivity Type II examples

Hypersensitivity Type III 

failure to remove antigen-antibody complex to continue inflammation due to activation of cascade via releasing C3a and C5a

*Prolonged reaction

*AB mediated

scarring, tissue destruction, excessive inflammation

clinical manifestations of Type III

Hypersensitivity Type IV

delay of cellular reaction to antigen by failure of T-cells to respond appropriately and cause tissue damage

*Cell-mediated

tissue damage

clinical manifestation of tissue damage

granulomatous, tuberculin-type, and contact dermatitis

Hypersensitivity Type IVa

persistent asthma

Hypersensitivity Type IVb

Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis

Hypersensitivity IVc

Pustular psoriasis

Hypersensitivity IVd

Hodgkin disease

malignant B-cells (Reed-Sternberg cells) that are abnormally large and multinucleated

Originates in lymph node and move node to node

clinical manifestations of HL

movable and painless nodes (cervical, axillary, inguinal)

B symptoms - fever, night sweats, weight loss

pain when drinking alcohol

Hepatomegaly

Splenomegaly

Anemia

Stage I of HL

lymphoma in single lymph node region

Stage II of HL

presence of lymphoma in 2+ lymph node region on same side of diaphragm

Stage III of HL

spread of lymphomas to nodes on both sides of diaphragm

Stage IV of HL

widespread metastasis of lymphomas to extranodal locations (other organs)

Non-Hodgkin’s lymphomas

malignant B cells, T cells, or NK cells (mostly B cells) that is characterized by scattered node involvement and non-organized pattern of widespread mets

Clinical manifestations of NHL

Moveable and painless nodes

B symptoms with fatigue, malaise, pruritus

Decreased WBC count (appear like leukemia)

Hypermetabolism - causes anemia, leukopenia, immune disorders

Lymphadenopathy

Splengomegaly

Lymphocytosis

Plasma Cell Myeloma (Multiple myeloma)

neoplastic cancer of plasma cells of bone marrow where antibody production is inhibited

*Impairs blood cell production and proper immune regulation

Monoclonal gammopathy of undetermined significance

abnormal plasma cells that produce lower levels of M proteins, marking the beginning of MM

M proteins

excessive AB cells resulting from the proliferation of B cells following MGUS presence

Clinical manifestations of MM

• Hyperviscosity syndrome common - mucosal bleeding, visual changes, and neurological symptoms

• Skeletal - osteoporosis, pain in pelvis/spine/ribs, compression of spinal cord, pathologic fractures, hypercalcemia

• Neurologic - confusion, seizures, coma, blurred vision, headache

• Renal - polyuria, renal failure, damaged proximal tubules, pyelonephritis

• Circulatory - cardiac abnormalities, anemia, thrombocytopenia/neutropenia

• GI - anorexia

• Common cause of death - overwhelming infection

  • Immune system compromised unable to defend self