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 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.

EpidemiologySLE occurs world wide More common in women then male (9:1)Peak age of onset b/w 20-40 years

CAUSESUnkown but predisposing factor like,HeredityGeneticsComplement deficiencySex hormone

PathogeenesisIt is immunological response to lupus

(antigen presenting cells)stimulate B cell to producing antibodies against Ro and la eg.

PathologySLE is a vasculitis affecting

capillaries ,arterioles and venules ,with fibrinoid material is found in venules and tissue fibers .

Clinical featureFever is common occur 50% of cases.Joints and musclesSkinLungsCardiovascular systemKidneysNervous systemEyesG I T

LUPUS VariantsChronic discoid lupusDrug induced SLEOver lap syndromeAnti phospholipid syndrome

InvestigationsComplete blood pictureSerum anti nuclear antibdiesdsDNA antibodyOther antibodies ,,,,,Rheumatic factor 25% of ptsSerum complement levelAnti phospholipid antibodiesHistology Imaging

TreatmentConfirmed diagnosisCounselled about disease

prognosis ,prevention of complication and sun light exposure

NSAIDsAntimalarial drugsCorticosteroidsImmunosuppressive drugs New therapy like Anti –CD20 monoclonal

antibodies and new trials ongoing

Prognosis SLE episodic or remissions phaseChronic persistent condition10 year survival is about 90% ,but lower in

organ based complication.

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