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DR SANTOSH KUMAR ASSISTANT PROFESSOR MEDICINE UNTI 2. Autoimmune Disease. Auto immune disease are condition in which the immune system damages its own bodt tissue causes ill health . auto immune disease include graves disease , hashimoto thyroiditis
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Autoimmune Disease Auto immune disease are condition in which the immune system damages its own bodt tissue causes ill health . auto immune disease include graves disease ,hashimotothyroiditis pernicious anemia ,insulin dependent diabeted mellitus and rheumatoid arthritis and systemic lupus erythematous .
Systemic lupus Erythematous[SLE] • SLE is an inflammatory ,multisystem disorder with sign and symptom of artharlgia and rashes ,with cerebral and renal disease as serious complication.
Epidemiology • SLE occurs world wide • More common in women then male (9:1) • Peak age of onset b/w 20-40 years
CAUSES • Unkown but predisposing factor like, • Heredity • Genetics • Complement deficiency • Sex hormone
Pathogeenesis • It is immunological response to lupus (antigen presenting cells)stimulate B cell to producing antibodies against Ro and la eg.
Pathology • SLE is a vasculitis affecting capillaries ,arterioles and venules ,with fibrinoid material is found in venules and tissue fibers .
Clinical feature • Fever is common occur 50% of cases. • Joints and muscles • Skin • Lungs • Cardiovascular system • Kidneys • Nervous system • Eyes • G I T
LUPUS Variants • Chronic discoid lupus • Drug induced SLE • Over lap syndrome • Anti phospholipid syndrome
Investigations • Complete blood picture • Serum anti nuclear antibdies • dsDNA antibody • Other antibodies ,,,,, • Rheumatic factor 25% of pts • Serum complement level • Anti phospholipid antibodies • Histology • Imaging
Treatment • Confirmed diagnosis • Counselled about disease prognosis ,prevention of complication and sun light exposure • NSAIDs • Antimalarial drugs • Corticosteroids • Immunosuppressive drugs • New therapy like Anti –CD20 monoclonal antibodies and new trials ongoing
Prognosis • SLE episodic or remissions phase • Chronic persistent condition • 10 year survival is about 90% ,but lower in organ based complication.