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AUTOIMMUNE DISEASES

AUTOIMMUNE DISEASES. DR IDA DZIFA KUWORNOO PHYSICIAN SPECIALIST KBTH. Greek word ‘auto’ meaning self. Due to failure of an organism to recognize its own constituent parts as self leading to an immune response against its own cells and tissues.

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AUTOIMMUNE DISEASES

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  1. AUTOIMMUNE DISEASES DR IDA DZIFA KUWORNOO PHYSICIAN SPECIALIST KBTH

  2. Greek word ‘auto’ meaning self. • Due to failure of an organism to recognize its own constituent parts as self leading to an immune response against its own cells and tissues. • Body’s own immune system begins to attack normal tissues cells and organs within the body.

  3. Secretion of proinflammatory cytokines • Antigen presentation • T-cell activation • Autoantibody productionand self-perpetuation B cell B cell B cell Dendritic cell Plasma cell IL-6 IL-10 TNF- T cell RF TNF- Macrophage RF RF RF RF Fix complement IL-1 IL-10 TNF- IL-6 Inflammatory damage Inflamed synovia (Dörner & Burmester, 2003; Edwards et al, 1999; Gause & Berek, 2001; Shaw et al, 2003; Takemura et al, 2001; Zhang & Bridges, 1986) Cartilage loss Potential Roles of B Cells in the Immunopathogenesis of RA

  4. Predisposing factors • Genetics eg.HLADR2-SLE and M. Sclerosis • HLADR3 SLE, Sjogrens, Myasthenia ,DM type 1 • HLADR4 R. Arthritis, Pemphigus vulgaris • Environmental

  5. Sex :They tend to have female preponderance 75%. • Usually pubertal or childbearing age group • Hormonal

  6. Infections :Bacterial or viral e.g. Klebsiella pneumoniae, Chlamydia, Coxsackie virus B. • Parasitic infections may be protective • Drugs • Toxins ,pesticides.

  7. Classification • Local eg Diabetes mellitus type 1,Graves disease, Addisons disease • Systemic eg. SLE, Rheumatoid arthritis, polymyositis etc

  8. GIT:e.g Crohns ,PBC,Autoimmune hepatitis • ENDOCRINE:e.g Type 1 diabetes,Graves disease,Hashimotos thyroiditis • SKIN e.g.pemphigus vulgaris • NERVOUS SYSTEM e.g.multiple sclerosis,CIDP • HAEMATOLOGIC e.g.autoimmune hemolytic anaemias,pernicious anaemia • RESPIRATORY e.g.COPD ,sarcoidosis

  9. Symptoms and signs • Malaise • Fatigue • Rashes • Hair loss • Febrile illness • Recurrent miscarriages • Visual impairment • Joint swellings or pain

  10. Memory loss • Limb weakness • Strokes

  11. DIAGNOSIS • Accurate history of the illness • Physical examination • High index of suspicion

  12. LABORATORY TESTS • Varied probable depends on system involved. • Blood counts ,kidney function tests etc Serological assays for diagnosis, expensive • MRI’S • Biopsies for local involvement

  13. Treatment Non medical • Multidisciplinary • Counselors • Physiotherapists • Occupational therapists

  14. Treatment • Non immune therapy e.g. hormone replacement in thyroid disease, type 1 diabetes • Immune modulatory drugs e.g. Steroids, TNF inhibitors etc. • Anti inflammatory e.g. NSAIDS • Palliative

  15. Together fourth largest cause of death among women. • Affects more people than heart disease in the USA • Poorly understood poorly recognised • Need for more awareness

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