what disease is associated with anti-centromere antibodyNinety-six percent of patients with detected anticentromere antibody in the serum have CREST syndrome.
primary and secondary Sjögren syndromeprimary→sicca syndrome
secondary→occurs with other autoimmune disease (e.g. RA) rheumatology May 10, 2019, 12:56 AM HirotoShishido
inclusion body myopathy
common type(封入体筋炎)
(myocytes led to apoptosis by autoimmune process)
sporadic(quadriceps are affected)is more common than hereditary(tibialis anterior are affected) rheumatology May 10, 2019, 8:18 AM HirotoShishido
Felty syndromerheumatoid arthritis
splenomegaly
neutropenia rheumatology May 10, 2019, 6:53 AM HirotoShishido
extraarticular manifestation of RAskin→rheumatoid nodules
lung→interstitial lung disease,pleuritis,pleural effusion
heart→pericarditis
kidney→AA amyloidosis
nerve→carpal tunnel syndrome rheumatology May 10, 2019, 6:52 AM HirotoShishido
3 specific defromities to rheumatoid arthritisulnar finger deviation (MCP joints)
swan neck (MCP joints)
boutonniere=buttonhole deformity(PIP joints) rheumatology May 10, 2019, 6:46 AM HirotoShishido
how the citrullination cause rheumatoid arthritistype Ⅱ collagen and vimentin can be
modyfied when arginine convert into citrulline
immune cells are sometimes not clever enough to recognize these proteins as self antigens(due to gene susceptibility) rheumatology May 10, 2019, 6:37 AM HirotoShishido
types of dermatomyositis with poor prognosisclinically amyopathic dermatomyositis(CADM) rheumatology May 9, 2019, 2:10 PM HirotoShishido
Dermatomyositis typical autoantibody①anti aminoacyl-tRNA synthetases(ARS) antibody
anti Jo-1 antibody(→antibody targetting synthetase which combines histidine and t RNA)
②anti MDA-5 antibody
positive in 20〜30% of DM
positive→50% are associated with negative→rarely associated with
rapidly progressive interstitial lung disease(RP-ILD)
③anti Mi-2 antibody
④anti transcriptional intermediary factor-1(TIF-1) antibody
positive in 20% of DM
50%〜75% of the individuals are associated with malignant tumor rheumatology May 9, 2019, 2:02 PM HirotoShishido
Picturecalcinosis cutis→ CREST syndrome
calcinosis cutis,Raynaud's phenomenon,esophageal dysfunction(←atrophy and fibrous replacement of the muscularis in the lower esophagus) ,sclerodactylia, telangiectasia rheumatologymusculoskeletalUWorld May 8, 2019, 11:51 PM HirotoShishido
color change in Raynaud phenomenonvasospasm cause ischemia(white)→hypoxia(blue)→reperfusion(red) rheumatology May 8, 2019, 12:12 AM HirotoShishido
Evans syndrome
Which autoimmune disease is this associated with?warm autoimmune hemolytic anemia(warm weather is Great→IgG)+immune thrombocytopenic purpura
how to distinguish polymyalgia rheumatica and polymyositispolymyalgia rheumatica →CK
polymyosistis ↑CK rheumatology May 9, 2019, 2:18 AM HirotoShishido
DM muscle and skin symptomsskin→Heliotrope rash(violaceous紫 periorbital),Gottron papules,shawl and face rash(ショール徴候),malar rash
muscle→bilateral weakness,muscle atrophy,tenderness,pain(mostly proximal)
dysphagia rheumatology May 7, 2019, 3:35 AM HirotoShishido
IgA vasculitis(Henoch Schonlein purpura, HSP)
triad+1・skin (palpable purpura on the buttocks and lower extremities, 下腿伸側左右対称隆起性紫斑)
・GI (intermittent severe abdominal pain, upper and lower GI bleeding, intussusception)
・joints (migratory arthralgias and arthritis in large joints of the lower extremities)
・kidneys (IgA nephropathy)
symptoms and joint findings of osteoarthritis and rheumatoid arthritisOA
no swelling,sharp ache
morning stiffness less than an hour(come back at the end of the day)
☆synovial fluid noninflammatory, dislodged pieces of cartilage and subchondral bone, joint space narrowing
RA
painful swelling
morning stiffness more than an hour
improve with use(Lambart Eaton)
increased synovial fluid(inflammtory) rheumatologymusculoskeletal Apr 7, 2019, 1:14 AM HirotoShishido
scleroderma
histopathological findings☆dermal layer expansion due to diffuse deposition of collagen (eosinophilic connective tissue), resulting in ☆atrophy of the intradermal adipose tissue and dermal appendages (ie, hairfollicles, glands). dermatologyrheumatologyUWorld Apr 1, 2020, 11:39 AM HirotoShishido
