Autoimmune Disorders 2014

1. Autoimmune Disorders2014 By Mrs. Farquharson’sfavourite class ever 

2. order to help the lack of dopamine and the self injury issues. Diazepam, haloperidol, or phenobarbital help maintain and behavioral problems. Keeping hydrated can also help alleviate the pain and symptoms of LeschNyhan. Restraints can also be used to stop self injury tendencies. PROGNOSIS With support from family members, and medications to help alleviate symptoms a person with this disease is likely to live into their twenties but they will have these symptoms for the rest of their life. There are few cases of people with this disorder living past 40. The cause of death is most often sudden respiratory failure, or kidney failure or from aspiration pneumonia. There is currently no preventive measures for this disease, but they are currently studying whether this disease could be treated using gene therapy. LeschNyhan  BY STACEY FINNEGAN • Difficulty swallowing • Impaired kidney function • Weak muscle tone • Uncontrollable muscle movements • Difficulty speaking • Severe gout arthritis • Muscle stiffens • Urine that looks like orange sand • DIAGNOSIS • What is frequently referred to as orange sand in an infant’s diaper is usually a suggested way to diagnose LeschNyhan Syndrome. A blood or urine test can also beused in order to check uric acid levels, or even to check the amount of HPRT enzymes to check for an abnormal count to confirm a diagnosis HISTORY Lesch, Michael (born 1939), and Nyhan, William Leo (born 1926) Lesch analyzed blood and urine for amino acids because he had such a fascination with them. The urine of a pair of patients, two brothers was very interesting to him because he foundorange crystals in their urine, the brothers also seemed to be suffering from an unknown disorder. Nyhan, aided by Lesch, investigated these symptoms, and discovered the disease in 1964. WHAT IS IT? LeschNyhan syndrome, is an autoimmune disorder that almost exclusively targets males (there are only 7 cases of this disease occurring in females).This is because it occurs on the X chromosome, which males only have one of rather than females who have two, which causes the rarity in females. It is caused by a recessive gene trait. It occurs when there is a mutation in the HPRT1 gene, called hypoxanthine phosphoribosyltransferase 1. In this syndrome when this enzyme is lacking it causes an overproduction of uric acid, which causes neurological and behavioral problems. This also causes a lack of dopamine, which helps your emotional feedback. It happens to 1 in 380,000 people. People with this disorder have been thought to have severe learning disabilities due to their low IQ testing scores, when in reality people with this disease just have a very short attention span. This is why they no longer believe that people with this disorder are mentally handicapped. It is often found in childhood years rather than adulthood. VIDEO SIGNS AND SYMPTOMS • Irritablity • Nervous system issues including, not being able to lift head, lack of muscle tone, unusual arch of back , inability to crawl, stand or walks, and spasms of the limbs and facial muscles. • Blood in the urine • Pain and swelling of joints • Difficulty swallowing • Behavioral problems and self injury Orange coloured crystal like deposits in the diaper • Kidney stones • Pain and swelling in the joints TREATMENT There are no specific treatments for this syndrome, you could talk allopurinol (aploprim) can help lower the uric acid in the body to prevent kidney and joint damage, but cannot fully fix it. Medication such as baclofen may be given to help with muscle spasms. Antidepressants could be used in

3. Acute Disseminated Encephalomyelitis[ADEM] Demographics What is it? The first animal model of encephalomyelitis was discovered by Thomas M. Rivers and Francis F. Schwentker. Hospital of The Rockefeller Institute for Medical Research, in 1934. Causes A rare inflammatory characterized by a brief but widespread attack of inflammation in the brain and spinal cord. Affects the central nervous system. More specifically the Myelin. Background Contributing Factors Occurs in 10 – 20 out of 100,000 people. 100 out of 100,000 in developing countries. 3 to 6 ADEM cases each year in the US, UK and Australia. ADEM is found in all ethnic groups. 80% in people less than 10 years old. 20% in second decade of their life. 3% in adulthood. The ratio of boys to girls is 1.3:1. Depends on your health. Prognosis Post infectious – ADEM activates during or after an infection. Post immunization – ADEM activates after getting a immunization. No cure but there are treatments. Some include anti-inflammatory and immunosuppressive drugs. Plasmapheresis, when your plasma is separated from the blood. /a·cute/ - /dis·sem·i·nat·ed/ - /en·ceph·a·lo·my·eli·tis/ Recovery is usually slow process lasting from four to six weeks. Majority make a full recovery, 60% to 90% are left with no neurological deficits. Those that do have residual symptoms are reported to have symptoms of spinal cord inflammatory attack, recurrent headaches, and behavioral problems. Diagnosis is based on clinical and radiologic characteristics. When individuals develop multifocal neurologic abnormalities, if the symptoms happens 1 to 2 weeks after a viral/bacterial infection or a vaccination. Complete blood count. Serologic studies. Blood Cultures. Lumbar puncture. MRI of the brain and spine. Signs And Symptoms Diagnosis Treatment

4. Addison's Disease  By: Dylan Sanichara Background Addison’s disease is named after Dr. Thomas Addison, a British physician who first described the condition in 1849. The disease was considered fatal then, and before 1930, 90% of people affected died within the first five years. - One of the most notable cases of Addison's disease was United States president John F. Kennedy Causes • Type 1 Diabetes • Hypopituitarism (when the pituitary gland does not produce enough of one or more of its hormones) • Hypo or Hyperthyroidism • An abdominal injury • Having surgery on the adrenal glands • A family member having Addison’s could also increase the risk Addison’s Disease can be difficult to diagnose as the symptoms are typically vague The most accurate way to test diagnose Addison’s is to measure the hormone levels in the blood and urine one ACTH has been given to the patient What is Addison's disease? Addison's disease is a disorder that occurs in the endocrine system. It occurs when your body does not produce enough amounts of certain hormones produced by your adrenal glands. Specifically, they don’t produce enough cortisol and aldosterone. Cortisol – Is a hormone that comes from the adrenal gland and is secreted during times of stress and is sometimes called “the stress hormone” however when it is secreted in small amounts there are a number of benefits such as: • A quick burst of energy for survival reasons • Increased memory functions • A burst of increased immunity • Lower sensitivity to pain • Helps maintain homeostasis in the body Aldosterone – works primarily on the kidneys to help maintain the balance of fluids and electrolytes in the body. It mainly works to control the reabsorption rate of sodium and chloride and secretion of potassium Prognosis/Homeostasis • Addison’s disease sometimes develop what is known as Addisonian crisis Treatment The basic principle of treating Addison's involves replacing or substituting the hormones that the adrenal glands are no longer producing enough of Cortisol is replaced orally with tablets Aldosterone isn’t usually prescribed in most cases of Addison's disease Natural Treatments Herbs such as Borage, Siberian Ginseng and Huang Qi support the function of the adrenal glands and help fight stress Ginger is also used to fight nausea and vomiting Yoga Tai Chi Meditation Acupuncture Diagnosis Blood and urine tests will be taken to test for low levels of aldosterone and cortisol and also high levels of ACTH (Adrenocorticotropic hormone) which is a hormone that stimulates the adrenal glands They will also measure levels of: Chloride Sodium Potassium Calcium Blood urea nitrogen levels An X-ray or CT scan may also be done to check for calcium deposits on the adrenal glands Hyperpigmentation or darkening of the skin or gums Demographics Addison’s disease is relatively rare, therefore not many countries are documenting cases for a census. However some that are documenting cases include: United States: about 1 in 100,000 Great Britain: 39 cases per 1 million Denmark: 60 cases per 1 million Addison’s disease is also classified as s “rare disease” by the National Institutes of Health in the US which means that it affects less than 200,000 people in the United States.

5. CANALE-SMITH SYNDROME K-dell Salandy • ALL DEPENDS ON CLINICAL FINDINGS. • LABORATORY ABNORMALITIES. • CHRONIC. • NON-MALIGNANT. • NONINFECTIOUS LYMPHADENOPATHY. • SPLENOMEGALY.(SPLV) • MOLECULAR GENETIC TESTING.(PGD) • AUTOIMMUNE LYMPHOPROLIFERATIVE SYNDROME(ALPS). • INHERITED DISORDER. • THE BODY CANNOT PROPERLY REGULATE THE NUMBER OF LYMPHOCYTES. • ABNORMAL LARGE NUMBER OF LYMPHOCYTES. • LACK IN LONG TERM DATA SINCE (ALPS) IS A RARE RECENTLY IDENTIFIED DISEASE. • PATIENTS CAN LIVE TO ADULTHOOD. • HYPERSPLENISM. • CORTICOSTEROIDS. • SIROLIMUS. • ENLARGEMENT OF SPLEEN, LIVER AND LYMPH NODES.. • SKIN RASHES. • ANEMIA. (SOFA) • VERY RARE DISORDER, ITS PREVALENCE IS UNKNOWN. • MORE THAN 100 PEOPLE AFFECTED IDENTIFIED WORLDWIDE.

6. ANTIPHOSPHOPHOLIPID SYNDROME • Demographics: • COD is usually from • Infection (20%) • Stroke (19%) • Cardiac failure (17%) • Multi-organ failure (17%) • What is it? • Autoimmune disease • Clogs blood vessels through blood clotting • Causes complication in pregnancies • Treatment: • Goal is to prevent blood clots • Prevent pregnancy complications • Ex. warfarin, aspirin, heparin, compression socks • Healthy diet • Contributing Factors: • Effects woman more than men • Usually effects ages 30 and up • Prognosis: • Treatment is life long • Lifestyle changes are made • Significant improvement with coagulation therapy • Diagnosis: • Blood Tests • Looking for Anti-phospholipid Antibodies • Difficult to diagnose Maslow's Hierarchy of Needs: Level: Physical

7. Myasthenia Gravis By Eleanor Furtado About myasthenia gravis This disease does not have a very specific target demographic Usually targets women under the age of 40 and men over the age of 60 (National Institute of Neurological Disorders and Stroke, 2010) Contributing factors for this disease are not well understood Demographics The effect that MG has upon physical homeostasis directly correlates with the severity MG also has an effect on the emotional well-being of the patient, and can lead to a feeling of insecurity concerning the future MG and homeostasis Signs of MG include: Drooping eyelids (ptosis) Muscle fatigue Trouble swallowing Trouble speaking Weakness of the arms and legs Difficulty breathing Abnormal facial expressions Shortness of breath These symptoms are often mistaken for other conditions initially due to how broad they are ( National Institute of Neurological Disorders and Stroke, 2010) Signs and symptoms There are a variety of diagnostic tests, such as: A blood test Endrophonium test Diagnostic imaging Electromyography testing(National Institute of Neurological Disorders and Stroke, 2010) Myasthenia gravis is caused by a disruption in the normal function of the nervous system It occurs when the body begins to form IgG antibodies that target acetylcholine receptors between muscles and nerve endings ( National Institute of Neurological Disorders and Stroke, 2010) Diagnosis Myasthenia gravis is not curable, however the symptoms of the disorder can be controlled via the use of certain medications Medicines include cholinesterase inhibitors, corticosteroids, immunosuppressants, plasmapheresis and a thymectomy(Mayo clinic staff, 2013) Alternative treatments for MG are available however they have not been thoroughly researched and vary from source to source Alternative treatments include vitamin supplements, diet adjustments and psychological therapy Treatment options Myasthenia gravis, though once a hopeless prognosis, can now be controlled so that the patient can enjoy a good quality of life Many patients now have a normal life span Prognosis

8. Celiac Disease Inflammation caused by the ingestion of gluten will cause great damage to the villi of the small intestine What is Celiac Disease In someone with celiac disease, the presence of gluten destroys the function of these villi and causes severe damage to the small intestine each time gluten is ingested. How does this affect me? Why Does my Body do this? Celiac Disease is a disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. Who discovered this strange disease? Celiac Disease was first discovered by a man named Aretaeus of Cappadocia, in 250 A.D, although he had know idea the cause and coined people suffering with this disease as "koiliakos," which meant "suffering in the bowels.“. Francis Adams later translated the term from Geek into English, and gave the suffers the name “Celiacs” or “Coeliacs”. It was not until 1952, that a Dutch pediatrician linked the indigestion of wheat proteins as a cause of Celiac Disease. Celiac disease in an auto immune disease! This means that antibodies are produced against substances naturally present in the body. Symptoms may vary from person to person…. Some symptoms include: Diarrhea or constipation, or both Stomach pain Abdominal bloating Gas Is their a cure? The doctor may decided to do either a blood test (or a series of) and/or a biopsy of the small intestine. Celiac disease does not have a cure. How is this diagnosed? Homeostasis Celiac Disease is a disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. Who discovered this strange disease? Celiac Disease was first discovered by a man named Aretaeus of Cappadocia, in 250 A.D, although he had know idea the cause and coined people suffering with this disease as "koiliakos," which meant "suffering in the bowels.“. Francis Adams later translated the term from Geek into English, and gave the suffers the name “Celiacs” or “Coeliacs”. It was not until 1952, that a Dutch pediatrician linked the indigestion of wheat proteins as a cause of Celiac Disease. How do you get Celiac Disease? Is remission possible? Celiac Disease is typically genetically passed on. But, if you suffer from any/many other auto immune disorders it does make you more susceptible. Celiac Disease is a rare case of an auto immune because it is actually able to go into remission. What are the symptoms?

9. SARCOIDOSIS Sarcoidosis can effect any tissue in the body. Inflammation, as a response to foreign material in the body, does not go away, although the foreign material has. This inflammation leads to granulomas in the tissue, which cause problems. But sarcoidosis is non-life threatening and has the possibility of healing without treatment. What Is It? Treatment & Medication Causes The definitive cause of sarcoidosis is unknown, but it is thought to be a reaction triggered by that of the immune system. The immune system is called in to combat some sort of foreign material, the inflammation during this process, does no go away as it usually would. This inflammation leads to the granulomas which causes sarcoidosis. Diagnosis & Tests Doctors determine if a patient has sarcoidosis by eliminating other diseases or illness. This is done by review of medical history, routine exams, and a multitude of tests. Chest X-Ray: gives picture of lungs and heart to look for inflammation of tissues (lymph nodes) Pulmonary Function Test: find out if lungs are working properly; breathe into machines that records the lungs capacity; the lungs of sarcs patients do not do this properly Blood Test: see how well cells are functioning, measures blood protein levels; can show abnormal liver function; check for ACE a type of enzyme that is released by granulomas Bronchoaveolar Lavage: uses bronchoscope to wash out materials from inside lungs and examined for amount of cells that reflect inflammation; high number = inflammation in lungs Biopsy: examination of lung tissues; tells doctors where granulomas have formed Gallium Scanning: injects gallium into vein, collects in areas where sarcs and inflammation have collected Still-Lamp Examination: take a lamp and look at the inside of the of the eyes Outlook: Mortality & Morbidity Survivable Usually not crippling Often goes away on its own Most cases heal within 24-36 months Patients can live as per usually whether or not sarcs goes away Non-contagious for loved ones, friends, co-workers No evidence of sarcs being genetic Many recover with few to no long-term issues Methotrexate Leflunomide Azathioprine Mycophenolate Infliximab Adalimumab Pentoxifylline Chloroquine Thalidomide Inhaled corticosteroids Prednisone Equivalent Cyclophosphamide Etanercept IgG Who Gets It? white women are just as likely as white men to get sarcoidosis, but black women get sarcoidosis twice as often as black men. estimated to affect 64 out of 100,000 people anyone can get sarcoidosis all races and in both sexes risk is greater if you are a young black adult, especially a black woman, or are of Scandinavian, German, Irish, or Puerto Rican origin (for reasons unknown) It is rare Although sarcoidosis can rarely occur in families, there is no evidence that sarcoidosis is passed from parents to children Naturally heals in 60-70% of cases 20-30% of cases may develop chronic sarcoidosis Mary Sultana| Farqs | Our Lady of Mount Carmel Shortness of breath Inflammation of body tissues Coughing wheezing Lumps, ulcers, and/or discoloration of skin Chest pain Enlarged spleen liver, salivary glands Tender lymph nodes Signs & Symptoms

10. DRESSLER’S SYNDROME • What is it? • Inflammation of pericardium because of damaged tissue (heart attack, surgery ect.) • Also known as post- cardiac injury and post myocardial infarction syndrome • Targets males • What body system it affects:1. Circulatory 2. Respiratory • History Who: William DresslerWhen: 1956 Where: Brooklyn New York in Maimonides hospital • Demographics • How common is it? • not common; it is a rare disease • Numbers of patients with dressler’s have been going down • Signs And Symptoms • 1-6 weeks after surgery involving paricardiotomy • Chest pain • Fever • Shortness of breath • Causes • immune response • Diagnosis • Blood test • X-rays • Listening to the heart • Treatment • DRUGS: • Asprin • NSAIDs • Pain medication • IgG, IgM • Prognosis • Can occur multiple times • Homeostasis Personal Care

11. Berger’s disease (IgA nephropathy) • What is Berger’s disease? • -it is a common type of kidney disease • Inflammation of the kidneys • Discovered by Jean Berger in 1986 Treatment -there is no treatment but there are ways to slow down the disease What is the cause? There are unknown causes of Berger’s disease but it can be associated with genes, liver disease and infections Demographics -IgA Nephropathy is found in: - 40% in Asia - 20% in Europe - 10% in North America Body system In Berger’s disease the immune system effects the urinary system How is it tested? -Urine test -Blood test -Kidney imaging -Kidney biopsy • The storyof • Donald Jones References

12. HASHIMOTO’S THYROIDITIS • TREATMENT • Hormone replacements are taken • Attempting to achieve a balance in hormones • Levothyroxine is most common and best results • Daily tablet every day • WHAT IS IT • The thyroid is being attacked by the immune system • Immune system even goes as far to use lymphocytes to produce antibodies against it • No cure • What is Being Affected? • Endocrine system  thyroid is the affected gland; its role is to produce hormones for bodily functions and activities • Immune system  starts attacking its own body and produces antibodies to fight against the thyroid • TESTING AND DIAGNOSIS • Physical examination • TSH test (blood test)  Best test and most accurate results • Hormone test (blood test) • Antibodies test (blood test) • TSH test will tell severity of condition and dosage needed • Who is Affected? • Women 7x more likely than men to be diagnosed • Aged 30 – 60 years is most common range • Influenced by genes, gender, medical history • Homeostasis and Symptoms • Change in hormones results in a change in appearance and body function • RELIEVING SYMPTOMS • Levothyroxine will relieve symptoms and bring balance to hormone levels • Additionally reversing symptoms • PREGNANCY • Pregnancy needs to be planned and prepared for • Altered dosage will be required • No breast feeding is suggested by doctors • Levothyroxine can be passed through breast milk • HISTORY • Discovered by Hakaru Hashimoto • Japanese physician • Kyushu University Medical School • Discovered in 1912

13. Kawasaki Disease What is Kawasaki Disease? How can this affect you? • - Myocarditis: Swelling of theheart muscle 3. • -Pericarditis: Swelling of the sac around the heart3. • -Arrhythmias: Abnormal heart beat3. • Symptoms: • Photos 5 • Cause is unknown 2. • May be a severe reaction to a common virus 2. • Seems to be a genetic component to the disease 2. • No specific test 4. • Tests may be run in order to rule out other diseases 4. • Diagnosis is made if the child has at least 4 of the listed symptoms 7. • Inflamed blood vessels can slow or even stop the delivery of oxygen and nutrients to body cells8. • Therefore, cells won’t be getting the proper nutrients to survive= cell death 8. • Main treatment: Intravenous gamma globulin(a medication given though vein or IV)1. • Effective if given within 10 days1. • Aspirin helps control fever, rash, and swollen joints1. • Without treatment- full recovery but there may be complications 2. • With treatment- Complications are much less likely 2. • It’s a rare condition that primarily targets children usually under the age of 6 years old 6. • Demographics: • 20 in every 100,000 children3. • Prevalent in Asian and Pacific Island decent, especially in boys 12. • Can affect many parts of the body including: • Mucus membranes 3 • Skin 3 • Eyes 3 • Lymph nodes 3 • Can cause problems with the heart 3: • -Vasculitis:Inflamed blood vessels3. • -Aneurysm: a weak area in a blood vessel enlarges 11. Demographics: Symptoms: Treatment: Cause: Diagnosis: Prognosis:

14. SYSTEMIC LUPUS ERYTHEMATOSUS  • CAUSE • No known cause for lupus • Environmental and genetic factors are assumed included in causes for lupus SLE Diagnosis Diagnosis uses acronym DOPAMINE RASH Discoid rash Oral ulcers Photosensitive rash Arthritis Malar rash Immunologic Phenomenon Neurologic phenomenon Renal involvement ANA Positive Serositis Hemoatologicalphenomenom ___________________________________ -To be classified as having SLE a patient must meet 4 of the following 11 symptoms at any time since the onset of disease Body Systems Affected • Lupus affects almost all body systems such as nervous, integumentary, cardiopulmonary, renal, gastrointestinal, reproductive, musculoskeletal • Some people get skin and joint inflammation while others may have more serious affects on the kidney’s, lungs, blood and heart. Drugs Used BACKGROUND There are four main people that have contributed to Lupus: - Rogerius -Moriz Kaposi -Sir William Osler - Josef Jadassohn -Nonsteroidal anti-flammatory drugs -Antimalarial drugs -Corticosteroids to counter inflammation -Immunosuppressive drugs Alternative Methods African American women who have lupus have a higher morality rate than Caucasian women [Replace, move, resize, or delete graphic, as necessary.] What is Lupus? Autoimmune disease Immune system cannot differentiate between healthy cells and antigens Begins making antibodies against healthy cells Prognosis -unpredictable -Historically lupus has caused people to die young -Today if someone with lupus does the proper treatments, uses the proper medication, and lives a healthy life, they are expected to live a normal live span. Females are diagnosed 10-15 times more than males

15. Ménière'sDisease 5 Treatment & Lifestyle There is no cure for Ménière's Disease currently. There are treatments that can help relieve and treat the symptoms such as medications for vertigo, long term medications, noninvasive therapy, special middle ear injections or in some cases surgery. Lifestyle changes include diet, stress and anxiety management, avoiding smoking (nicotine makes symptoms worse) and allergens (make symptoms more servere) along with changing eating habits (eating regularly) and ensuring proper rest during vertigo episodes. Diagnosis • Physical examination & Medical History • Based on signs and symptoms, the doctor will perform a physical examination and looking into medical history for • Sensory problems • History of allergies/infectious diseases • Medication • Past ear problems • Overall health • Family ear problems 4 1 What is Ménière's Disease? Ménière's disease is a disease affecting auditory system of the nervous system. In the early 1820s in France, Prosper Ménière a doctor found a disease resulting of hearing loss caused from the ear itself. The ear has tubes called labyrinths which are filled with fluid. An overflow of fluid can disrupt the balance causing spontaneous and chronic symptoms such as a hearing loss. There is a labyrinth membrane with tiny hairs that respond to movement of the fluid (endolymph). The sensory to the fluid create nerve impulses to the brain. Slide 2 6 Prognosis Living with Ménière's Disease is a low to zero mortality rate but a moderate morbidity rate. It depends on the stage of where the patient is and how severely affected they are by the symptoms of Ménière's Disease. Majority of the sufferers (60-80%) will not need disability help and will most likely recover with proper treatment and care. • Hearing Test • A hearing test will be conducted with an audiometrywhich assess the patients ability to recognize and react to sounds, pitches, volumes and frequencies. This test determines overall ear health and source of the problems within the ear. • Balance Assessment • Balance is greatly affected with Ménière's disease; having vertigo a main symptom. • Tests include: • videonystagmography (eye movement) • rotary-chair testing (stimulus to inner ear with movement of special chair) • Posturgraphy (computer finds reliance in balance system) • Rule out Tests • Other tests to rule out Ménière's with similar symptoms • Magnetic Resonance Imaging (MRI) • Computerized tomography (CT) • Auditory brainstem response audiometry (hearing nerves/center of brain) 7 Demographics 2 Signs & Symptoms Worldwide it is considered a rare disease. This condition is more prevalent in older people, generally over the age of 60. This disease has an equal effect for both genders and its more likely to be found in Caucasians and least in African American races. Slide 17 • Signs and Symptoms include: • Vertigo (minutes-days length of attacks) • Loss of hearing in affected ear • Tinnitus (ringing) in affected ear • Pressure/full feeling in affected ear • Loss of hearing balance • Headaches • Nausea 8 Personal Effect and Support Depending on the severity and case of the individual living with meniere’sdiease they can be place as far as safety on Maslow’s Heirachy of Needs. There are support groups that People can join where they can Find support through other people Living with the same condition 3 Cause • The cause of Ménière's disease is the imbalance of fluid in the ear tubes (labyrinths). The cause of the imbalance is unknown. There are a wide variety of possible contributors.

16. Narcolepsy By: Jodi Maloles • People with narcolepsy usually begin to show signs and symptoms in their late teens, to early 20’s, but can show symptoms in their 40’s. • Signs and symptoms include: • EDS (excessive daytime sleepiness) • Cataplexy • Sleep paralysis • Fatigue • Automatic behaviour • Hallucinations • Nightmares • Insomnia* • Treatment/ Prognosis • There is no cure but medication is given to relieve symptoms. • [References] Narcolepsy or ‘hypnolepsy’ is a chronic neurological disorder that causes severe daytime sleepiness. Earlier this year, was this confirmed to be an auto immune disease. Earliest discovery was in the 17thcentury. Diagnosis There usually needs to be a referral to a sleep study based on symptoms given to a family doctor. Diagnosis is based on tests and signs and symptoms.1. MSLT 2. Polysomnogram 3. Hypocretin test 4. Epworth Sleepiness Scale The body system affected is the nervous system. Homeostasis becomes effected in the sleep-wake cycles. Demographics vary from each country, however in Canada and the United States, it is 1 in every 2000 people. It is also said to affect both men and women equally. There are very few factors correlating to narcolepsy. http://www.narcolepsy.org.uk/public_files/AgeAtOnset.png

17. Neutropenia  What are the effects on the body? -mostly affects mucous membranes -skin and mouth Respiratory and digestive tract What is the cause? -medications -destruction of neutrophils by antibodies • Viral infections • Not heriditary Who is at risk? • Cancer, specifically leukemia. • chemotherapy/ radiation therapy patients • People over 70 • Men and women • Infants, young children Treatments -anitbiotics/ antifungal medications -granulocyte colony-stimulating factors -corticosteroid therapy -intravenous immune globulin Prognosis -can last from months to years -acute neutropenia lasts 3 months -chronic neutropenia lasts more than 3 months Symptoms -skin conditions (ulcers, abscesses, rashes) -infections (sinus, ear) -gingivitis -pneumonia -Fever -chronic bacterial infections Diagnosis -complete blood count/full blood count (CBC/FBC) -intermittent CBC/FBC -antibody blood test -bone marrow aspirate -bone marrow trephine biopsy -cytogenetic and molecular testing What is it? -an abnormally low count of neutrophils (white blood cells that fight off infection) -neutrophil count is less than 1000-1500 microliters -most common among infants and young children What are the different types? -congenital –cyclic -autoimmune -idiopathic

18. Demographics • - 160,000 diagnosed cases in the USA • - Thousands of undiagnosed cases due to common and overlapping symptoms • - Males to female prevalence is a 2.6:1 ratio • Contributing Factors • - Experiment conducted of 23 PANDAS patients • - 19 had history of autoimmune disease within blood relatives • - 20 had history of mental health issues with blood relatives • - Presence of A-beta-hemolytic streptococcus bacteria intiated onset of symptoms • Diagnostic Criteria • 1. OCD and/or tics • 2. Aged between 3 to 15 (puberty). • 3. Episodic recurrence of symptoms • 4. A-beta-hemolytic streptococcus infection • 5. Association with neurological symptoms • - PANDAS is a clinical diagnosis • - Throat culture to test for strep Treatment 1. Prophylactic antibiotics e.g. Penicillin and Azithromycin are administered for long periods of time to prevent strep infection 2. Plasmapheresis - Plasma is removed through IV and substitute plasma is replaced back into the blood stream 3. CBT (Cognitive Behavioral Therapy) - Family involvement and support to cope with neurological symptoms such as OCD and tics 4. IVIG (Intravenous Immunoglobulin - Donated immunoglobulins (IgG) administered through IV - Proven to alleviate tics and OCD (Rhodes, 2013) 5. Corticosteroids - Reduce inflammation of basal ganglia Prognosis - Preventing and treating strep infections have demonstrated eradication of symptoms - As the thymus shrinks, PANDAS is less prevalent History of PANDAS - Discovered in the 1980’s at NIMH in Maryland - Discovered by child psychiatrists Dr. Swedo, Dr. Rapoport and Dr. Leonard. What is PANDAS Disease? - Autoimmune disease triggered by the presence of the A-beta-hemolyticstreptococcus bacteria - The antibodies attacking the streptococcus bacteria become confused and attack the basal ganglia - Present only in children exposed to the streptococcus bacteria How will PANDAS affect my child? Nervous System - Severe OCD - ADHD - Mood swings - Anxiety - Motor and verbal tics - Learning difficulty Immune System - IgG deficiency - Increased susceptibility to infection PANDASPEDIATRIC AUTOIMMUNE NEUROPSYCHIACTRIC DISORDER ASSOCIATED WITH STREPTOCOCCUS

19. PSORIASIS  Demographics: Psoriasis praevalence in African Americans is 1.3 percent compared to 2.5 percent of Caucasians 5 different types of psoriasis: 1) Plaque 2) Guttate 3) Inverse 4)Pustular 5)Erythrodermic Treatments 1) topical creams (creams and ointments that can help mild to moderate psoriasis) 2) Topical corticosteroids 3) Vitamin D Analogues 4) Topical retinoids 5) Phototherapy How did this disease come about? • One of the longest known ilness known to humans • Ferdinand von Hebra What is it affecting? Affects your immune system and integemnatry system Triggers Stress Enviorment (cold, dry) Medications Infections (like HIV) Diagonsis: Physical diagnosis (can be done by examining the skin) Skin biopsy Medical history Alternative therapy: Soak in warm water (not too hot) Moisturize (heavy and greasy moisturizers) Humidify (dry air is not good for psoriasis) Causes No known cause Believe could be genetic Prognosis: No cure but there are ways to reduce flare ups and live with it ] Organizations : You are not alone References

20. Scleroderma Symptoms: • Treatments: • No cure for Scleroderma • Anti inflammatory • medication: • NSAID’S • Corticosteroids • Alternative medication: • Therapy • Surgery • Lifestyle and at home remedies What is Scleroderma? Scleroderma is a autoimmune disease that affects the skin and some internal organs. Prognosis: Depending on the type of Scleroderma, the survival rates may be higher. Body Systems affected: Integumentary system Circulatory System Digestive System Pulmonary System Musculoskeletal System • Contributing factors: • Age and gender • Genetics • Environmental Two major types of scleroderma: Localized Scleroderma Affects mainly the skin but can spread to muscles, joints and bones. Systemic Scleroderma Affects the skin muscles, joints, blood vessels, lungs, kidneys, heart and other organs. • Demographics: • 16000 Canadians will be affected (mainly women) • Worldwide: 2.5 million Diagnostic Tests: Blood test Pulmonary function test Electrocardiogram Echocardiogram Gastrointestinal tests Kidney Functions test Homeostasis: Physiological Founder of Scleroderma: Carlo Curzio References Alexis Yang

21. Contributing Factors • age • Hodgkin’s disease • viral infections • surgery • rabies or flu shot • The Effects of GBS • Body System • rare autoimmune disorder found in the peripheral nervous system • destruction of myelin sheath of the nerves • Homeostasis • unsteadiness • weakness • tingling • numbness • pain • possible paralysis • What is GBS? • autoimmune disorder • attacks their nerve cells which are what communicate with the muscles in our body Diagnosis Electromyography (EM): An electrode gets inserted underneath the skin and muscle, so that it can get an electrical recording of muscle activity Lumbar punctures (spinal tap): Sample of spinal cord fluid is taken and tested for bleeding, spinal cord proteins and infection Blood test: Helps to rule out any other possible causes • Causes • no found cause • They will mistakenly attack eh nerve tissue rather then the foreign antigen • most commonly found infection that were found in most GBS patients was human gastroenteritis (food poisoning)or the influenza virus (flu) Guillian Barré Syndrome (GBS) • Traditional Treatments • Intravenous Immunoglobulin • Antibodies are taken from a healthy donor and are injected into the patient’s vein • Plasmapheresis (plasma exchange) • Tries to remove the cells that causes the attack in the GBS • Rehabilitation • patient may require rehabilitation in order to regain regular function • Alternative Treatments • maintain a healthy diet • History of GBS • First description • in 1859 • in Europe • French physician, Jean Landry • Who discovered GBS? • in 1916 • Georges Guillian, Jean-Alexandre Barré, and Andre Strohl • How was GBS discovered? • performed test on soldiers and saw a common abnormality between the two • they had an increase in production of spinal fluid protein with a normal cell count and no inflammation • Prognosis • recovery process is about four weeks after the first signs • about 4/5 patients fully recovered within a year • 10% of cases cause nerve damage • Potential problems with their breathing, tingling and numbness • Demographics • 1 to 2 out of 100,000 Americans diagnosed • 1,500 out of 61 million people in the UK are diagnosed annually • mostly common in males • affects all ages References

22. Stiff man’s syndrome George Saad Pictures prognosis Introduction Stiff man’s syndrome is a rare neurological disorder with features of an autoimmune disease1. It is categorized in as an autoimmune disease because of the production of antibodies against GAD • No cure :( • Most used treatments: • High doses of diazepam ( controls muscle spasms) • Gabapentin ( Less seizures) • IV Ig treatment effectively reduces the stiffness and muscle spasms. • LOTS OF STERIODS!*** Signs and symptoms • signs and symptoms: 1 • Stiffness • Muscle spasms(usually lower back and legs) • Noise/touch can trigger the above • Extreme muscle twitches • Anxiety • (sometimes) bipolar • Classical: diabetes 1/ stiffness statistics Interesting statistics Affects twice as much women as men Usually found in older ages (40-60) Diagnosis/procedure • electromyography (EMG) • Antibody testing • Physical exam2 • Problem with diagnosis? 3 • Often diagnosed as diabetes, Parkinson's, MS, Dystonia ( Abnormality of the tone of tissue).

23. Rheumatoid Arthritis • What is it? • Form of inflammatory arthritis and an autoimmune disease. • Chronic affecting the joints of the body. • RA affects the lining of you joints, causing painful swelling, stiffness and/or soreness that can eventually result in joint deformity. • Anyone can get RA and there is no exact cause • Signs and Symptoms • Joint inflammation • Stiffness • Swelling • pain • Redness and warmth • Decreased range of motion • Achy muscles • Diagnosis • No single test done for RA • Specific blood tests are performed • Treatments • There is no cure but there are many treatments. • Treatments include: • Lifestyle changes • Medicine • Surgery • Regular doctor visits • Physical therapy • Complementary therapy • Prognosis • RA can get better or worse with time • Different for everyone and depends on factors • Age at time of diagnosis, health and any complications developed • Remission • Reduction in signs and symptoms • Factors of remission include: • Physical exam • Blood tests • Self-reported symptoms • Imaging tests

24. Kawasaki Disease • What is Kawasaki Disease? • It’s a rare condition that primarily targets children usually under the age of 6 years old 6. • Kawasaki disease is characterized as an inflammation of the blood vessels throughout the body. • Can affect many parts of the body including: • Mucus membranes • Skin • Eyes • Lymph nodes • Can cause problems with the heart: • Vasculitis: • Inflammation of the blood vessel. • Happens when the body’s immune system attacks the blood vessels by mistake. • In Kawasaki Disease, the coronary arteries are primarily affected. • Aneurysm: • A weak area in a blood vessel enlarges and forms a bubble looking thing. • Myocarditis: Swelling and inflammation of the heart muscle. • Pericarditis: Swelling of the sac around the heart. • Arrhythmias: Abnormal heart beat. • Symptoms: • Fever for at least five days • Red, patchy skin rash on the trunk and around the groin • Swelling and redness in the hands and feet, with peeling skin later on • Bloodshot eyes • Swollen lymph nodes in the neck • Red, swollen, cracked lips, mouth, throat and tongue (sometimes called strawberry tongue) • Some children also get swollen joints, pain, stomach ache, diarrhea and vomiting. • How can this affect you? • Inflamed blood vessels can slow or even stop the delivery of oxygen and nutrients by the blood to the body cells. • If this happens cells won’t be getting the proper nutrients to survive= cell death. • Cause: • Cause is unknown. • May be a severe or unusual reaction to a common virus. • Seems to be a genetic component to the disease. • Demographics: • 20 in every 100,000 children. • Prevalent in Asian and Pacific Island decent, especially in boys. • Diagnosis: • No testing is done that specifically diagnoses Kawasaki Disease. • Tests may be run in order to rule out other diseases such as electrocardiograms (ECG), echocardiography, chest x-rays, and blood tests. • A diagnosis is made if the child is experiencing at least 4 of the previously listed symptoms. • Treatment: • Main treatment is Intravenous gamma globulin(a medication given though vein or IV) • Intravenous Gamma Globulin: a protein that contains many antibodies and slows down the destruction of platelets. Helps prevent blood clots. • Effective if given within 10 days. • Aspirin is given in order to help control the fever, rash, and swollen joints. • Prognosis: • Without treatment the child should make full recovery but there may be complications which include: • -Developing an aneurysm: this can lead to a blood clot which can ultimately lead to a heart attack or heart disease. • -Sometimes it may burst and cause severe internal bleeding. • -25% of children with Kawasaki who don’t get treatment end up experiencing those heart related complications. • With treatment- Complications are much less likely.