Autoimmune disorders

Scleroderma

A rare, chronic disease characterized by excessive deposits of collagen. Causes skin thickening and tightening, and can involve fibrosis and other types of damage to internal body organs. This condition, thought to be an autoimmune disease, affects both adults and children, most commonly adult women. he most evident symptom is the hardening of the skin and associated scarring. Typically the skin appears reddish or scaly in appearance. Blood vessels may also be more visible. W here large areas are affected, fat and muscle wastage will weaken limbs and affect appearance.

Sjogren's Syndrome Laboratory Test

ANA and RF positive

Goodpasture's Syndrome

An uncommon and life-threatening hypersensitivity disorder believed to be an autoimmune process related to antibody formation in the body. Goodpasture's syndrome is characterized by renal (kidney) disease and lung hemorrhage

Goodpasture's Syndrome (2)

Antibodies react with antigens in the glomerular basement membrane of the kidney, results in severe necrosis. Antigen in kidney is similar to antigen found in lungs, resulting in antibody reacting with lung tissue resulting in pulmonary hemorrhage. Specific anti-basement antibodies can be demonstrated.

Myasthenia Gravis (2)

Antibody mediated damage to acetylcholine receptors in skeletal muscles leading to progressive muscle weakness. Acetylcholine released from nerve endings to generate muscle contraction. Antibody combines with receptor site, blocking acetylcholine binding. Receptors destroyed by action of antibody and complement.

Myasthenia Gravis Laboratory Testing

Autoantibodies to the Acetylcholine receptor (AChRAb) can be detected in 80-90% of patients with myasthenia gravis. The assay measures antibodies that precipitate solublized muscle AChR that has been complexed with radiolabeled alpha- bungarotoxin (αBTX). Antibodies that bind to the receptor regions that are not sterically blocked by the αBTX are detected.

Insulin Dependent Diabetes Mellitus

Autoimmune process causes destruction of cells in the pancreas resulting in insufficient insulin production. Occurs before age 20, peak onset between 10 and 14 years. Inherited susceptibility. Environmental influences include possibility of viral infections.

Multiple Sclerosis (2)

Because the myelin is damaged, messages moving along the nerve are transmitted more slowly or not at all which slows or blocks muscle coordination, visual sensation and other nerve signals.

Scleroderma (2)

CREST syndrome Calcinosis Raynaud's Esophageal dysmotility Sclerodactyly Telangiectases

Multiple Sclerosis Diagnosis

Cerebrospinal fluid (CSF) is tested for levels of certain immune system proteins and for the presence of oligoclonal bands. These bands indicate an abnormal autoimmune response within the central nervous system, meaning the body is producing an immune response against itself. Oligoclonal bands are found in the spinal fluid of about 90-95% of people with MS, but since they are present in other diseases as well, they cannot be relied on as positive proof of MS. They may also take some years to develop.

Graves' Disease - Thyrotoxicosis

Characterized by HYPERTHYROIDISM. Nervousness, insomnia, depression, weight loss, heat intolerance, breathlessness, fatigue, cardiac dysrhythmias, and restlessness. Women more susceptible, occurs most frequently between 30 and 40 years of age. Genetic link suspected.

Goodpasture's Syndrome Diagnosis

Complete blood count (CBC) Blood urea nitrogen (BUN) and creatinine levels Urinalysis will be done to check for damage to the kidneys. Sputum test to look for specific antibodies. Chest x ray to assess the amount of fluid in the lung tissues. Lung needle biopsy and a kidney biopsy will show immune system deposits. Kidney biopsy can also show the presence of the harmful antibodies that attack the lungs and kidneys Antiglomerular basement membrane (anti-GBM) antibody Enzyme immunoassay (EIA) Antibodies to Neutrophil Cytoplasmic Antigens (ANCA) identified by immunofluorescence

Goodpasture's Syndrome Treatment

Corticosteroids Plasmapheresis Dialysis

Graves' Disease

Diagnosis may be straightforward, since the "classic face" with its triad of hyperthyroidism, goiter, and exophthalmos is easily recognized. Goiter is usually symmetric, smooth, and nontender The hyperthyroid state, which is by far the most common component of Graves' disease, can cause a wide variety of multisystem derangements that often result in diagnostic confusion.

Exophthalmos

Exophthalmos, also called proptosis, is a characteristic finding in thyroid eye disease, and has been reported to occur in 34% to 93% of patients

Myasthenia Gravis Symptoms

Facial weakness, Difficulty chewing and swallowing, Inability to maintain support of trunk, neck or head.

Hashimoto's Thyroiditis

Hashimoto's Thyroiditis is a type of autoimmune thyroid disease in which the immune system attacks and destroys the thyroid gland. The thyroid helps set the rate of metabolism - the rate at which the body uses energy. Hashimoto's prevents the gland from producing enough thyroid hormones for the body to work correctly. It is the most common form of Hypothyroidism (underactive thyroid).

Hashimoto's Thyroiditis (3)

Hashimoto's thyroiditis is the most common cause of hypothyroidism. It is also most prevalent in elderly women and tends to run in families. Hashimoto's thyroiditis occurs eight times more often in women than men. Certain chromosomal abnormalities include Hashimoto's thyroiditis as a symptom.

Insulin Dependent Diabetes Mellitus Treatment

Injected insulin. Immunosuppressive drugs for newly diagnosed patients.

Myasthenia Gravis

It is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. It is the most common primary disorder of neuromuscular transmission

Graves' Disease Treatment

Medication. Radioiodine therapy to destroy the thyroid. Surgical removal of thyroid

Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, potentially debilitating disease that affects the brain and spinal cord (central nervous system). Destruction of myelin sheath of axons results in formation of lesions (plaques) in white matter of brain and spinal cord. Causes inflammation and injury to the sheath and ultimately to the nerves. The result may be multiple areas of scarring (sclerosis). Cause may include genetic and environmental factors. Most often seen between ages of 20 and 50.

Signs Symptoms

Nervousness and increased activity, Grave's disease patients may suffer a fast heartbeat, fatigue, moist skin, increased sensitivity to heat, shakiness, anxiety, increased appetite, weight loss, and sleep difficulties. They also have at least one of the following: an enlargement of the thyroid gland (goiter), bulging eyes, or raised areas of skin over the shins.

Sjogren's Syndrome Treatment

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen Corticosteroids Saliva substitutes Artificial tears or eye drops Cyclosporine A (Restasis) eye drops

Hashimoto's Thyroiditis (2)

Organ specific disease affecting the thyroid gland. Most often seen in women 30 to 40 years old, may be genetic predisposition. Common cause of hypothyroidism. Causes diffuse hyperplasia in the gland resulting in development of a goiter. Thyroid autoantibodies are formed.

Laboratory Tests Scleroderma

Presence of serum anti-Scl-70 antibodies Antinuclear antibody (ANA or FANA) Rheumatoid Factor (RF) Antibody to single stranded DNA (ssDNA) Soluble interleukin 2 receptor level (sIL 2 r).

Graves' Disease Laboratory Testing

Presence of thyroid-stimulating hormone receptor antibody, causes release of thyroid hormones. Key findings are elevated total and free T3 (triiodothyronine) and T4 (thyroxine), the thyroid hormones. Thyroid stimulating hormone (TSH) is reduced due to antibody stimulation of the thyroid.

Sjogren's Syndrome (2)

Sjogren's syndrome classically features a combination of dry eyes, and dry mouth . Most often occurs secondary to RA, SLE or other autoimmune disorders Dry eyes and mouth due to damage to secretory ducts. 90% of cases found in women.

Sjogren's Syndrome

Sjogren's syndrome is an autoimmune disease, characterized by the abnormal production of extra antibodies in the blood that are directed against various tissues of the body. This particular autoimmune illness is caused by inflammation in the glands of the body. Inflammation of the glands that produce tears (lacrimal glands) leads to decreased water production for tears and eye dryness. Inflammation of the glands that produce the saliva in the mouth (salivary glands, including the parotid glands) leads to mouth dryness.

Goodpasture's Syndrome Symptoms

Symptoms include: foamy, bloody, or dark colored urine, decreased urine output, cough with bloody sputum, difficulty breathing after exertion, weakness, fatigue, nausea or vomiting, weight loss, nonspecific chest pain and/or pale skin

Telangiectasias

Telangiectasias are small enlarged blood vessels near the surface of the skin, usually they measure only a few millimetres. They can develop anywhere on the body but commonly on the face around the nose, cheeks and chin

Insulin Dependent Diabetes Mellitus Indications for Laboratory Testing

Testing should be conducted at earlier ages and carried out more frequently in individuals who are any of the following: obese; have a first degree relative with diabetes; are members of a high-risk ethnic population (African-American, Hispanic, Native American, Asian); have delivered a baby weighing more than 9 pounds; have had gestational diabetes; are hypertensive; have HDL cholesterol levels equal to or less than 35 mg/dl or triglyceride levels equal to or greater than 250 mg/dl; or who, on previous testing had impaired glucose tolerance or impaired fasting glucose.

Insulin Dependent Diabetes Mellitus Laboratory Testing

The American Diabetes Association (ADA) recommendations for diagnosing diabetes state that patients be told they have diabetes if any of the criteria below applies: Fasting plasma glucose is above 126 mg/dl; Diabetes symptoms exist and casual plasma glucose is equal to or above 200 mg/dl; or Plasma glucose is equal to or above 200 mg/dl during an oral glucose tolerance test. The ADA now also recommends that all individuals age 45 and above be tested for diabetes, and if the test is normal, they should be re-tested every three years. If genetic predisposition is suspected perform testing to detect antibodies to pancreatic islet cells. Antibodies to insulin detected by RIA or ELISA methods

Calcinosis

The buildup of calcium deposits in the tissues. It may occur under the skin of the fingers, arms, feet, and knees, causing pain and infection if the calcium deposits pierce the surface of the skin.

Hashimoto's Thyroiditis Laboratory Testing

The diagnosis of Hashimoto's thyroiditis is simply diagnosed by two blood tests. Routine thyroid function tests to confirm that a patient has an underactive thyroid gland. Anti-microsomal and anti-thyroglobulin antibodies are immune cells which the body produces to attack specific portions of the thyroid cells which pinpoint Hashimoto's thyroiditis as the cause of the hypothyroidism. The anti-microsomal antibody test is much more sensitive than the anti-thyroglobulin, therefore some doctors use only the former blood test. These thyroid autoantibodies blood tests are high in about 95% of patients with Hashimoto's thyroiditis, but are not diagnostic.

Hashimoto's Thyroiditis Symptoms

The following are the most common symptoms. However, each individual may experience symptoms differently: goiter (enlarged thyroid gland which may cause a bulge in the neck) other endocrine disorders such as diabetes, an underactive adrenal gland, underactive parathyroid glands, and other autoimmune disorders fatigue muscle weakness weight gain

Multiple Sclerosis Treatment

The treatment of MS focuses mainly on decreasing the rate and severity of relapse, reducing the number of MS lesions, delaying the progression of the disease, and providing symptomatic relief for the patient. Several different drugs have been developed to treat the symptoms of MS. Drug treatment depends on the stage of the disease as well as other factors.

Goiter

This enlargement is due to the inflammatory cells which destroy thyroid cells, resulting in long term scarring. When the cells are damaged they cease thyroid hormone production, resulting in hypothyroidism A goiter only needs to be treated if it is causing symptoms. The enlarged thyroid can be treated with radioactive iodine to shrink the gland or with surgical removal of part or all of the gland (thyroidectomy). Small doses of iodine (Lugol's or potassium iodine solution) may help when the goiter is due to iodine deficiency.

Hashimoto's Thyroiditis Treatment

Thyroid hormone replacement. Spontaneous remissions have occurred.

Thyroid

Thyroid hormones are produced by the thyroid gland. This gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly - formed by two wings (lobes) and attached by a middle part (isthmus).

Sclerodactyly

When the fingers become tight, stretched, wax-like, and hardened

Insulin Dependent Diabetes Mellitus Complications

With its complications, diabetes is the seventh leading cause of death in the United States. Diabetes is the leading cause of new blindness in people 20-74 years of age. Ten to twenty-one percent of all people with diabetes develop kidney disease. People with diabetes are 2-4 times more likely to have heart disease. About 60%-70% of people with diabetes have mild to severe forms of diabetic nerve damage, which, in severe forms, can lead to lower limb amputations.

Raynaud's Phenomena

is a problem of poor blood flow to fingers and toes. Blood flow decreases because blood vessels in these areas become narrow for a short time, in response to cold or to emotional stress. Results in: finger sensitivity, toe sensitivity cold sensitivity, changes in skin color, finger pain, toe pain, fingertip ulcers, toe ulcers