Term
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Definition
- loss of tolerance to host constituents leads to immune driven organ damage w/ systemic inflammation
.usually idiopathic w/ exposure of genetically susceptible host to inciting agent in appropriate setting
-autoantibodies are common, as markers or as part of pathology |
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Term
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Definition
-naive T cells in the presence of self Ag and TGFb w/o inflammatory cytokines leads to production of FoxP3 a regulatory factor also CTLA4 a cell surface negative regulatory molecule, the glucocorticoid receptor, and more TGFb.
-in the presence of IL10 and more TGFb, immune suppression occurs
-Naive T cells in the presence of self Ag with IL6 and IL1(humans), TGFb (mice) leads to production of signalling molecules STAT3 and RORC which then produce IL17 TNF IL22 leading to inflammation
-AU dz -- excess T regs,
-Cancer -- too few T regs |
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Term
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Definition
| upregulated in RA, IBD, psoriasis other AU dzs |
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Term
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Definition
-Prevalence 0.8% pop, w/ affected sib 5%, w/ identical sib 25-30%
-multigenic >4 loci
-25-50% RA susceptibility from genetic factors
-strongest association, HLA DR 4 |
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Term
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Definition
-accumulation of insoluble fibrillar proteins (b pleated sheets)
-1 ary assoc w/ multiple myeloma, light chain amyloid, sxs of weakness, fatigue, neuropathy, CHF, nephrosis
-2 ary, assoc. with serum amyloid A made in liver as an acute phase reactant and seen in chronic infections, Fam Med Fever, Autoimmune Dzs such as RA, etc.Sxs are renal, GI, CHF is rare |
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Term
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Definition
-low level elevation in obesity, DM, atherosclerosis
-intermediate levels in CA, infection, RA
-high levels in sepsis |
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Term
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Definition
- facilitates transition from acute to chronic inflammation
-B cell differentiation factor, B cell to plasma cell, T cell differentiation to Th 17 |
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Term
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Definition
-overproduction of proinflammatory cytokines such as TNF, IL1, IL6, IFN g
-inadequate availability of serum iron and erythropoietin
-hepcidin- a liver derived peptide hormone regulates iron homeostasis, starves the "bug" of iron
IL6 stimulates hepcidin mRNA expression and increases serum hepcidin levels |
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Term
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Definition
- IL6 receptor is found only on hepatocytes and lymphocytes
- soluble IL6 receptor is anchored btw 2 gp 130 molecules which can sit on a variety of cells and then the IL6 comes along , binds and signal transduction occurs which leads to new gene expression |
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Term
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Definition
-gold standard for advanced dz
-INFLIXIMAB, CDP571, ADALIMUBAB,CERTOLIZUMAB,ETANERCEPT
-omab=murine, -ximab=chimeric, -zumab=humanized,-umab= human |
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Term
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Definition
-Caused by the bacteria Borrelia burgdorferi found in tick bites
-Sxs: 3-4 days, HA, LN, bull's eye rash erythema chronicum migrans (may be absent)
Weeks to months: CNS, eye ,
inflammation,cardiac- AV block
5 months, episodic oligo arthritis
chronic CNS sxs
Dx- serology ELISA, western blot
Rx- early- antibiotics, late-treat arthritis like RA |
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Term
| JRA (Juvenile idiopathic arthritis) |
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Definition
4 types
1- pauci articular (<4 jts), females> males, up to 50% w/ uveitis so checked by ophthom. 85% +ANA
2-polyarticular onset, rheumatoid nodules, progressive, 50%+RF
3- juvenile spondyloarthropathy,
male>females, sacroiliitis, 50% + HLAB27,
4- Systemic onset (Still's Dz), fever,rash serositis, ln, elevated ferritin,RA, ANA,ESR elevated >50% |
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Term
| Spondyloarthropathies(SpA)-Characteristics |
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Definition
disorders include-
ankylosing spondylitis, psoriatic arthritis, uveitis, reactive arthritis (Reiter's), undifferentiated SpA, SpA assoc w/ IBD, juvenile SpA |
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Term
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Definition
imflammatory axial arthritis, peripheral arthritis (asymmetric and oligo vs RA), HLA B27, 95% RF -, bony erosions, osteolysis, hyperostosis,spine fuses
males>females |
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Term
| SpA Extraarticular features |
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Definition
enthesitis, dactylitis (sausage digits),
ocular-conjunctivitis, uveitis: anterior (80%) assoc w/ B27 dzs, [FYI- posterior assoc w/ infections, anterior/posterior assoc w/ Bechets, sarcoid]
GI- oral ulcerations, gut inflammation,colitis,
GU- urethritis, vaginitis,balanitis
Cardiac- aortitis, valvular insuff, heart block
Cutaneous- onycholysi, dystrophy, pitting
cardiac- aortitis, valvular insuffolitis,
GU- |
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Term
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Definition
inflammatory arthritis of axial spine
HLA B27 >90% whites,20% risk in 1st degree relatives,males 5 to females 1, females less severe, onset 16-30, triad of am stiffness, immobility, inflammatory back pain, TNF inhibitors- substantial improvement |
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Term
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Definition
-seen in 12% pts w/ psoriasis,RF+ only in 5-15%, genetic component-35-50% concordance in twins,AS COMPARED TO RA:
more heterogeneous course and clinical expression, younger and males=females, oligoart and asymmetric, distal at presentation, SpA in 25% pts. |
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