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Quiz 3 review | September 25, 2013

Quiz 3 review | September 25, 2013. Quiz 3 Review. Autoimmune diseases Immunodeficiencies Transfusion Transplantation. Quiz 3 Review. Autoimmune diseases. Lupus. Typical patient: young woman with butterfly rash Symptoms unpredictable (relapsing/remitting)

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Quiz 3 review | September 25, 2013

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  1. Quiz 3 review | September 25, 2013

  2. Quiz 3 Review • Autoimmune diseases • Immunodeficiencies • Transfusion • Transplantation

  3. Quiz 3 Review • Autoimmune diseases

  4. Lupus • Typical patient: young woman with butterfly rash • Symptoms unpredictable (relapsing/remitting) • Multisystem (skin, kidneys, joints, heart) • Antinuclear antibodies Things You Must Know

  5. Lupus: butterfly rash

  6. Rheumatoid Arthritis • Symmetric, mostly small-joint arthritis • Systemic symptoms (skin, heart, vessels, lungs) • Rheumatoid factor • Cytokines (especially TNF) cause damage Things You Must Know

  7. Rheumatoid arthritis joint deformities

  8. Rheumatoid nodules

  9. Sjögren Syndrome • Inflammatory disease of salivary and lacrimal glands • Dry eyes, dry mouth • T cells react against some Ag (self? viral?) in gland; gland gets destroyed • Increased risk of lymphoma Things You Must Know

  10. Sjögren syndrome: salivary gland enlargement

  11. Scleroderma (Systemic Sclerosis) • Excessive fibrosis throughout body: skin, viscera • Claw hands, mask-like face • Microvascular disease also present • Diffuse and limited types Things You Must Know

  12. Systemic sclerosis: claw hands

  13. Systemic sclerosis: restricted mouth opening

  14. Quiz 3 Review • Autoimmune diseases • Immunodeficiencies

  15. Immune Diseases Outline

  16. Quiz 3 Review • Autoimmune diseases • Immunodeficiencies • Transfusion

  17. What are the products? • Whole blood • Red cells • Platelets • Granulocytes • Cryoprecipitate • Fresh frozen plasma

  18. FORWARD TYPE anti-A antibodies AHG patient red cells (type A) Forward typing is done using both anti-A and anti-B antibodies!

  19. REVERSE TYPE reagent red cells (type B) AHG patient serum (with anti-B Ab) Reverse typing is done using both type A and type B reagent cells!

  20. CROSSMATCH donor red cells AHG patient serum

  21. What can go wrong? • Transfusion reactions • hemolytic • non-hemolytic • Other complications • infections • circulatory overload • iron overload • graft-versus-host disease

  22. Quiz 3 Review • Autoimmune diseases • Immunodeficiencies • Transfusion • Transplantation

  23. Histocompatibility • Histocompatible: antigenically similar to the host • Histoincompatible: antigenically different from the host • MHC antigens are the most important • ABO antigens are also important • Minor histocompatibility antigens are less important

  24. HLA genes are inherited as sets! ♂ ♀ parents a/b c/d four possible haplotype combinations of children a/d b/c a/c b/d

  25. HLA alleles A B C DR DQ DP a 1 7 w3 2 1 1 b 2 8 w2 3 2 2 haplotypes c 3 44 w4 4 1 3 d 11 35 w1 7 3 4 HLA genes are polymorphic!

  26. number of mismatches Class I Class II 100 50 graft survival, % 3 6 12 time after transplant, months

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