Autoimmune Disease

Charecteristics	Lups	Sjogren	Sclerosis	Mixed
ANA	1.Anti-dsDNA,Anti-SM	1,Anti-Ribonucleoprotein	1.Anti-Centromere	Anti-U1 Ribonucleportein
	2.Anti-Phospholipid bound protein	2.Anti-SSA/Anti-SSB	2,Anti-Topoisomerase 1
	3.Drug Induced = Anti-Histone antiboies	Rheumatoid factor

1.Lupus

Wolf bite

• Type-3 Hypersensitivity reaction to Anti-nuclear antibiodes

Etiology

1. Exposure to UV ,DNA damage apoptosis and release of apoptotic bodies into blood
2. Complement deficiency in clearing apoptotic bodies result in auto-antibody,*forming antigen Antibody complex ***
3. Complex taken by dendritic cell to APC ,leads to more Antibody production

Symptoms

Relapse and Remission pattern

1. Vauge Symptoms
   • Fever ,weight loss
   • Raynoud Syndrome

     vast-spasm- White color vaso-dilation = Red color loss of blood supply = White color

11 Diagnostic Symptoms (4 out of 11 for positive diagnosis)

1. Butterfly rash  over the face/wolf bite like rash on skin on sunlight exposure
2. Oral or Nasopharyngeal ulcer
3. Arthritis
4. Serositis(Pleuritis or PEricarditis)
5. Psychosis or Seixures
6. Renal damage 
    - HEmaturia = Diffuse Proliferative GLomerulonephritis, Memebranous Glomerulonephrirtis 
7. Anemia, Thrombocytopenia/Leukopenia = *** Type-2 Hypersensitivity of RBC,Platelet,Neutrophils that carries the immune complex***
8. Lineman Sacks Endocarditis = Vegettive growth on both sides of Bi-cuspid valve
9. ANA positive 
10. ANti-dsDNa(***Prognosis of Disease***), Anti-SM antibodies
11. Other Type3 Hypersensitivity 
    - Antiphospholipid Antibodies(for proteins bound to Phospholipis)

        1. Anti-cardolipin Antibody( VDRL false positive) - as antibody is already produced due to autoimmune disease not from Syphilis
        2. Anti-Beta2-glycoproteins
        3. lupus anti-coagulant (false elevate PTT)
        #### Symptoms 
        1. risk of DVT,liver or brain thrombosis
    - Anti- Histone antibody from drug induced
        1. Procanamide,Hydralazine,isoniazid
        2. ANA is positive 
        3. CNS and Renal involvement rare 
        4. Removal drug cause remission

Treatment

• Avoid sunlight Exposure
• Steroids to suppress relapse

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2.Sjogren Syndrome

Type 4 hypersensitivity reaction to Salivary and Lacrimal glands

Symptoms

1. Dry eyes(dust in eyes) ,Can't Chew dry foods (dental carries)

Diagnostic

1. ANA,Anti-Ribonucleoprotein (Anti. - SSA & Anti-SSB)
   • Anti-SSA/Anti-SSB cross placenta to damage fetal tissue ,* need screeening in Sjogren + Pregnant females*
2. Rheumatoid factor (IgM)
3. Salivary gland biopsy(Can be lip tissue)
   • Lymphatic presence
   • *** may develop B-cell lymphoma*

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3.Systemic Sclerosis

Autoimmune disease characterised by sclerosis of LOcal and Systemic organs fibroblastic activation leads to deposition of collagen

Symptoms

graph TD
    X[Sclerosis] ==> X1[Local - limited local and late visceral] & X2[Systemic - local and early visceral involvement ]
    X1 ==>|HAnds and Face|  X1a[C - Calcinosis/ ***Anti-Centromere Antibodies***
    R- RAynaud phenomenon 
    E- Esophageal Dysmotility(sclerosis of :octicons-arrow-down-24:er esophagu associated with Barette esophagus
    S- Sclero dactyly loss of wrinkles in skin of hands 
    T -Telangiectasis overgrowth of Capillaries ];
    X2 ==>|***Anti-topoisomerase 1***|  [1.Blood vessels -Raynaud 
    2.GI - esophagealdismotility ,GERD
    3.Lungs - Intersitial fibrosis
    4.Kidneys - scleroderma renal crisis]

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4.Mixed Connective Tissue disorder

All three symptoms of SLE,Sjogren,Sclerosis and Polymyositis ANA and Anti - U1- ribonucleoprotein

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