Photosensitivity rash- SLE ,Dermatomyositis

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• Photosensitivity rash- SLE ,Dermatomyositis
• Papulosquamous lesions- Psoriatic Arthritis
  Reactive Arthritis
• Nodular lesions- RA ,Erythema Nodosum,Gouty
  Tophi ,Rheumatic Fever
• Palpable Purpura- Vasculitis ,Septic Emboli
• Ulcers Vasculitis -(RA,Wegeners,SLE),Systemic
  Sclerosis
• Aphtous Stomatitis SLE,Behcets,Wegeners

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??????? ????????

• Ant. Uveitis- ???? ???? ????? B27 ????? ?
  Seronegative Arthritis ?? JCA
• Post. Uveitis- ????? ???????????- Behcets
• Scleritis ???? ? RA,Wegeners ,SLE
• ????? ? Cornea Primary and Sec. Sjogrens

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????? ????????

• ????? ????????
• SLE ,RA
• ????? ?????????
• RA, SLE,AS,Systemic Sclerosis , PM/DM
• ????? ????????? ??????
• Wegeners ,Churg Strauss,SLE

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??? ????????

• ????? ???????????
• RA,SLE,Systemic Sclerosis,AS
• ????? ???????????
• RA,Systemic Sclerosis,PM/DM, RF,Amyloidosis
• ?????? ?????
• Systemic Sclerosis,PM/DM,AS,RF
• ????? ????????????
• SLE,APLA Syn. AS,Systemic Sclerosis

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???? ????????

• ???????? ?????? ?????????
• IBD,Reactive Arthritis,Whipples ,Celiac
• ???????? ?????? ????? ???
• ??????? ??????????? (HSP,PAN,,Behcets SLE)
• FMF , Amyloidosis,Systemic Sclerosis

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?????? ????????

• ????? ??????????
• SLE,Wegeners,Microscopic Polyangiitis
• HSP,Systemic Sclerosis,Amyloidosis
• ????? ??????????????
• SLE,Gout,Sjogrens
• ?????
• Gout

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Acute Phase Reactants

• ????? ??
• ????? ????? ???? ?? ?????? ? acute phase
  proteins ?????
• ?????? ????, ???, ?????? ???????? (????????
  ????? ????)
• ????? ????? ???? ????? ????

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Acute Phase Reactants

• CRP
• ????? ?" ????
• ???? ??? ???? ????? ??? ? SLE
• ??? ????? ????? ???? ?????
• ???? ????? ??? ??? ??? ?? ????

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Antinuclear Antibodies

• ?????? ????? ???????????????? ?? ELISA
• ??????? ????? ?? ?? ????? ???????????
• ????? ?????? ????? ????????-???? ??? 1160 ????
  ???? ??? ???????
• ?????? ?????? ?????? ????? ?????? ?????
  ???????????

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????? ??????? ???????? ANA

• ??????? ???????
• ?????????
• Lymphoma Leukemia
• Melanoma Solid Tumors
• ????? ?????
• Type 1 DM MS
• After organ transplantation
• ???????? ???????

• ????? ????????
• SLE RA Polymyositis
• SS Systemic Sclerosis
• Drug Induced
• ????? ??? ???????
• PBC CAH Alcoholic
• ????? ???? ???????
• Asbestosis IPF

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Antineutrophil Cytoplasmic Antibodies (ANCA)

• ?????? 2 ????? ???????
• cANCA ??????? ??? proteinase 3
• pANCA ??????? ??? myeloperoxidase
• ?????? ????? ??????? ?? vasculitis
• ????? ????? ????? ??????? ??? minocycline
  ,hydralazine , PTU

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Rheumatoid Factor

• ??????? ??? ???? Fc ?? ? IgG
• ?????? ?????? ????? ??? IgM ?? ?? ?????? ??
  ??????? ????? IgG IgD
• ???? ????? ELISA ???? ???? ????? LATEX
• ????? ?????? ???????????? ??????

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RF -?????? ????????
???? ?????? ??????? ??????
Rheumatoid Arthritis Sjogrens Syndrome 50-85
SBE SLE Chronic Liver Disease 25-50
Pulmonary Fibrosis Chronic T B 10-25
Ankylosing Spondylitis Psoriatic Arthritis OA 5-10
Normals 5-20 (age related)
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?????? ????? ??????

• Antiphospholipid Antibodies
• ?????? ????? ??????? ??? ?????????? aCL ??
  Lupus Anticoagulant
• Complement ???? ?????? ?????? ????? ??
• ???? ????????? ???????? ?????
• ??? ?????? ?? ????? (C2 C4 C1q )
• ????? ??????? ??????? ?? ????
• ASLO ??? ?????? ??????

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HLA B27

• ?????? HLA B27 ?????? ??????
• Ankylosing Spondylitis ??? 90
• Reactive Arthritis 60-75
• Psoriatic Arthritis ?????? 20 ??????? 50
• IBD with Arthritis ?????? ?? ????? ??????? 50
• Whipples Disease ?? ?????

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????? ?????????? ?????? ????? ??????

• ??? ????/????
• ????-?????????? , ?????? ????/?????????
• ????? ?????????? ?????
• ??????/OA ?? 500
• ????? ??? 1000 ? 70000
• ???? ??? 100000
• ?????

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?????? ????? ????????????

• ?????? ?????-?????????????,????????,???????????
• ???????,??????,????? ?????? ??????
• ????? ?????-???? ?????, ????? ?sacroilitis
• CT-???? ?????? ?? ????? ?"? ????? ?????-??????
• MRI-???? ??????? Myositis ???? ????? ?? AVN