Autoimmunity

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

sadhana on Dec 10, 2011 Says :

nice

kumaran on Oct 20, 2011 Says :

great pictures

emmy on Feb 22, 2011 Says :

thx

feby on Nov 02, 2010 Says :

very useful

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

Notes

Hide Notes

Slide 1 :

Autoimmunity Keith J. Kaplan, MD Mayo Clinic

Slide 2 :

Slide 3 :

Self-tolerance Central tolerance: primary lymphoid organs High concentration of self-antigens Clonal deletion B cell mechanisms Peripheral tolerance: peripheral tissue

Slide 4 :

Mechanisms of self-tolerance Clonal deletion: destruction of lymphocytes Clonal anergy: inactivation without cell death high concentration self antigens lack of immune stimulators Clonal ignorance: do not become activated Idiotype:anti-idiotype theory

Slide 5 :

Autoimmunity-mechanisms Failure of self-tolerance Molecular mimicry Release of sequestered antigens Change in self-antigens Genetic factors/MHC genes Hormonal

Slide 6 :

HLA-related diseases DISEASE ALLELE RR RA DR4 6 Ank Spon B27 90-100 CAH DR3 14 Hemochrom A3 8 IDDM DR3/DR4 20 Sjogren’s DR3 10

Slide 7 :

Antinuclear antibodies Against proteins, nucleic acids, nucleoproteins 3-15% population + at low titers Detection Immunofluorescence (Hep2) ELISA RIA (gold standard)

Slide 8 :

Immunofluorescence Divide nuclei into nucleoplasm, nucleolus, membrane; mitoses Main patterns Homogenous Peripheral Speckled Anti-nucleolar Anti-centromere

Slide 9 :

Homogenous IF pattern Diffuse nuclear IF Positive mitotic figures Anti-DNP, anti-histone, +/- anti-ds DNA SLE, drug-induced lupus

Slide 10 :

Slide 11 :

Homogenous IF pattern Uniform fluorescence; + mitoses

Slide 12 :

Peripheral IF pattern Rim highlighted; homogenous center Positive mitotic figures Anti-dsDNA SLE; correlates with lupus nephritis

Slide 13 :

Peripheral IF pattern Membrane highlighted; + mitoses

Slide 14 :

Speckled pattern Granular IF Negative mitoses Wide variety ANAs (ENAs) anti-Sm anti-RNP anti SSA/B anti-Scl-70

Slide 15 :

Speckled IF pattern Granular IF; negative mitoses

Slide 16 :

Anti-centromere Small dots within nucleus (46) Mitoses: dots clustered along mitotic axis CREST syndrome

Slide 17 :

Anti-centromere Finite number small dots; positive mitoses

Slide 18 :

Anti-nucleolar 2 to 7 large dots Negative mitoses Scleroderma (PSS) Also seen in SLE, Raynaud’s

Slide 19 :

Anti-nucleolar 2 to 7 large dots; negative mitoses

Slide 20 :

Anti-deoxynucleoprotein LE phenomenon Homogenous ANA 30-60% SLE patients

Slide 21 :

Anti-double stranded DNA Peripheral ANA Farr RIA is gold standard Crithidia luciliae Associated with SLE/ lupus nephritis

Slide 22 :

Crithidia luciliae Kinetoplast composed of ds-DNA

Slide 23 :

Autoantibodies Anti-histone Homogenous ANA pattern Drug-induced lupus Anti-Smith (anti-Sm) Speckled ANA pattern Specific for SLE 30% + in SLE

Slide 24 :

Autoantibodies Anti-ribonucleoprotein (anti-RNP) Speckled ANA pattern MCTD (mixed connective tissue disease) Anti-SCL-70 Speckled ANA pattern DNA topoisomerase Scleroderma

Slide 25 :

SSA/SSB/SSC Speckled ANA pattern Sjogren’s syndrome SSA: neonatal lupus/heart block SSC: Sjogren’s syndrome associated with Rheumatoid arthritis

Slide 26 :

Anti-mitochondrial antibody >95% primary biliary cirrhosis M2 antigen of pyruvate dehydrogenase

Slide 27 :

Anti-smooth muscle antibody 70-80% + in autoimmune chronic active hepatitis

Slide 28 :

Anti-parietal cell antibody Pernicious anemia 90% +

Slide 29 :

Hashimoto’s thyroiditis Anti-thyroid microsomal antibody > 90%+ Anti-thyroglobulin 50%+

Slide 30 :

Systemic lupus erythematosis Young females; age 15-25 ARA criteria Major autoantibodies ANA 95%+ anti-ds DNA 40-60%+ anti-Sm 30%+

Slide 31 :

Drug-induced lupus Many drugs: hydralazine, procainamide Many develop antibodies; few symptoms Slow acetylators of drugs Criteria drug association limited SLE-like picture anti-histone antibody negative anti-ds DNA/anti-Sm

Slide 32 :

Sjogren’s syndrome Dry eyes/dry mouth/ connective tissue disorder SSA (R0):80%+; SSB (La):50%+; SSC 3%+ SSC: 75% + when associated with RA Biopsy of minor salivary gland

Slide 33 :

CREST/PSS Calcinosis, Raynaud’s, esophageal dysmotility, sclerodactyly, telangiectasia Females, 4-5 decade, affects variety of organs Antibodies anti-centromere 95% + CREST anti-SCL-70 65% positive in PSS

Slide 34 :

MCTD Females, 2-3 decade Clustering of different symptoms, not specific for any one disease Antibodies high-titer anti-ribonucleoprotein antibodies 100%+ by definition

Slide 35 :

Rheumatoid arthritis Incidence 0.5% females, 0.1% males Joint pain/swelling, morning stiffness Antibodies RF: antibody (IgM) against Fc portion of IgG Heterogenous isotypes in RA anti-ds DNA 40% + Others at low titer

Slide 36 :

Other diseases Polymyalgia rheumatica temporal arteritis; ESR Ankylosing spondylitis HLA-B27 +; Reiter’s, uveitis Reiter’s syndrome Arthritis, uveitis, urethritis HLA-B27; infections (Shigella, Mycoplasma)

Slide 37 :

Organ-restricted diseases Wegner’s granulomatosis c-ANCA Dermatitis herpetiformis HLA-B8/DR3 IgA along D-E junction Celiac disease Anti-gliadin antibodies

Slide 38 :

Organ-restricted Myastenia gravis Acetylcholine receptors a/w thymoma, thymic follicular hyperplasia, pure red cell aplasia Polymyositis/dermatomyositis Adults: 5-10% underlying malignancy Anti-Jo-1 (histidyl-tRNA-synthetase)

Slide 39 :

Autoimmunity to the ...

Autoimmunity

Free Powerpoint Templates

	tissuepathology 5 Years ago.



8694 Views, 1 favourite
PowerPoint Presentation on Autoimmunity or PowerPoint Presentation on AutoimmunityClinical Patholog more PowerPoint Presentation on Autoimmunity or PowerPoint Presentation on AutoimmunityClinical Pathology Lecture less
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel