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16th February 2024
Autoimmune Systemic Disorders
Summary
Autoimmune conditions comprise a broad range of diseases caused by an inappropriate immune reaction to otherwise healthy human cells. The clinical course of the disease will depend on which cells are being targeted.
| Disorder | Symptoms | Target of autoantibody |
|---|---|---|
| Myasthenia gravis | Fatigable muscle weakness commonly involves the eye (ptosis) but can be more generalised. | Acetylcholine receptor |
| Pernicious anaemia | The inability to absorb B12 leads to macrocytic anaemia | Intrinsic factor, gastric parietal cells |
| Graves’ disease | Consistent with hyperthyroidism – weight loss, tremor, diarrhoea | TSH receptor |
| Hashimoto’s thyroiditis | Consistent with hypothyroidism – weight gain, constipation, fatigue | Thyroid peroxidase, Thyroglobulin |
| Goodpasture’s syndrome | Pulmonary haemorrhage, glomerulonephritis | Glomerular basement membrane |
| SLE | Various depending on the local site involved. Most commonly: constitutional symptoms, arthritis/arthralgia, Raynaud’s. Vasculitis, pericarditis, lupus nephritis | Double stranded DNA, ANA, Lupus anticoagulant |
| Rheumatoid arthritis | Symmetrical peripheral polyarthritis | Rheumatoid factor (IgG), Citrullinated peptide antibodies |
| Vasculitis | Various depending on the vessels involved | ANA, ANCA |
| Primary biliary cholangitis | Fatigue, pruritis, cholestatic LFTs, jaundice leading to liver cirrhosis | Mitochondria |
| Mixed connective tissue disorder | Overlapping features of systemic sclerosis, SLE and RA | Extractable nuclear antigens (ENA) |
References
- Virella G (2019). Chapter 2 Overview of hypersensitivity. Medical Immunology (7th ed) CRC Press
- Feather A, Randall A, Waterhouse M (2020). Kumar and Clark’s Clinical Medicine (10th ed). Elsevier
- Manole C et al (2011). Manifestations of Systemic Lupus Erythematosus. Maedica: A Journal of Clinical Medicine 6 (4): 330 – 336
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