AUTOIMMUNE DISEASES

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AUTOIMMUNE DISEASES

• DR IDA DZIFA KUWORNOO
• PHYSICIAN SPECIALIST
• KBTH

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• 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.
• Bodys own immune system begins to attack normal
  tissues cells and organs within the body.

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Potential Roles of B Cells in the
Immunopathogenesis of RA
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Predisposing factors

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

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

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

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Classification

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

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• GITe.g Crohns ,PBC,Autoimmune hepatitis
• ENDOCRINEe.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

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Symptoms and signs

• Malaise
• Fatigue
• Rashes
• Hair loss
• Febrile illness
• Recurrent miscarriages
• Visual impairment
• Joint swellings or pain

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• Memory loss
• Limb weakness
• Strokes

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DIAGNOSIS

• Accurate history of the illness
• Physical examination
• High index of suspicion

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LABORATORY TESTS

• Varied probable depends on system involved.
• Blood counts ,kidney function tests etc
• Serological assays for diagnosis, expensive
• MRIS
• Biopsies for local involvement

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Treatment Non medical

• Multidisciplinary
• Counselors
• Physiotherapists
• Occupational therapists

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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

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• 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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