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Immunopathology

Immunopathology. Ahmad Abu Alsamen MD. Auto immuno diseases. Organ-Specific Systemic Hashimoto thyroiditis Systemic lupus erythematosus Autoimmune hemolytic anemia Rheumatoid arthritis Autoimmune atrophic gastritis

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Immunopathology

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  1. Immunopathology Ahmad Abu Alsamen MD

  2. Auto immuno diseases Organ-Specific Systemic • Hashimoto thyroiditis Systemic lupus erythematosus • Autoimmune hemolytic anemia Rheumatoid arthritis • Autoimmune atrophic gastritis • of pernicious anemia Sjögren syndrome • Multiple sclerosis Reiter syndrome • Autoimmune orchitis Inflammatory myopathies* • Goodpasture syndrome Systemic sclerosis (scleroderm) • *Autoimmune thrombocytopenia Polyarteritis nodosa • *Insulin-dependent diabetes mellitus • Myasthenia gravis • Graves disease • Primary biliary cirrhosis*

  3. Clinical and Pathologic Manifestations of Systemic Lupus Erythematosus Clinical Manifestation Prevalence in Patients%, Hematologic 100 Arthritis 90 • Skin 85 • Feve 83 • Fatigue •81 • Weight loss63 • Renal l50 • Central nervoussystem 50 • Pleuritis 46 • Myalgia 33 • Pericarditis 25 • Gastrointestina 21 • Paynaud phenomenon 20 • Ocular • •15Peripheral neuropathy •14 • lesions result from the deposition of immune complexes and are found in the blood vessels, kidneys, connective tissue, and skin.An acute necrotizing vasculitis involving small arteries and arterioles may be present in any tissue.[68] The arteritis is characterized by fibrinoid deposits in the vessel walls. I

  4. Antinuclear Antibodies % in Various Autoimmune Diseases Antibody System SLE Drug-Induced LE Systemic Sclerosis— Limited Scleroderma sjogren syinf. myopathyANA) >95 >95 70– 90 70– 90 50–80 40-66 A Anti-double-stranded DNA 40–60 <5 <5<5 <5 <5 Anti histon AB 50–70 >95 <5 <5 <5 Anti-Sm 20=30<5 <5<5, <5 <5 SS-A(Ro) 30–50 <5<5<5 80 <5 Scl-70 <5 30-70 10 <5 <5 Anticentromere <5 <5 <5 95 <5 <5 Jo-1 <5 <5 <5 <5 <5 25

  5. \ • For the purpose of identifying patients in clinical studies, a person has SLE if 4 or more of the 11 criteria are present, serially or simultaneously

  6. Amyloidosis • disorder of protein metabolism accompanied with abnormal extracellular deposition of proteinaceous material - amyloid

  7. Amyloidosis • 90-95% non branched fibrils diam. 10-12nm • 5-10% p-component - glycoprotein + fibronectin, laminin, collagen 4

  8. Amyloidosis Classification: • According to the source protein (more than 20 different identified) • According to the distribution • systemic (generalised) • localised

  9. Amyloidosis • Primary amyloidosis • is the most common type ofamyloidosis • The protein deposits inprimary amyloidosisare made up of immunoglobulin light chain proteins. • These light chain proteins are created in the bone marrow by malfunctioning plasma cells.

  10. AmyloidosisClassification : • Amyloid light chain Primary amyloidosis amyloidosis . multiple myeloma AL light-chains (λ,κ) • SAA amyloid amyloidosis Secondary amyloidosis Chronic inflammation • ATTR amyloidosis familial amyloid polyneuropathies Transthyretin Senile amyloidosis Β2microglobulin Hemodialysis associated amyloidosis amyloidosis

  11. Amyloidosis Macroscopy: • small amounts invisible • larger deposits enlarged, firm, waxy organs

  12. Amyloidosis

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