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 HirotoShishido
3 specific defromities to rheumatoid arthritisulnar finger deviation (MCP joints)
swan neck (MCP joints)
boutonniere=buttonhole deformity(PIP joints) rheumatology 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 HirotoShishido
primary and secondary Sjögren syndromeprimary→sicca syndrome
secondary→occurs with other autoimmune disease (e.g. RA) rheumatology HirotoShishido
types of dermatomyositis with poor prognosisclinically amyopathic dermatomyositis(CADM) rheumatology 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 HirotoShishido
Evans syndrome
Which autoimmune disease is this associated with?warm autoimmune hemolytic anemia(warm weather is Great→IgG)+immune thrombocytopenic purpura
calcinosis cutis,Raynaud's phenomenon,esophageal dysfunction(←atrophy and fibrous replacement of the muscularis in the lower esophagus) ,sclerodactylia, telangiectasia rheumatologymusculoskeletalUWorld HirotoShishido
lupus heart symptomsLibman-Sacks endocarditis (LSE in SLE)
non-bacterial thrombotic endocarditis (NBTE)
→can also be caused by ☆advanced malignancy(especially pancreatic adenocarcinoma= Trousseau syndrome), less commonly antiphospholipid syndrome, DIC, extensive burns
→ can affect left sided heart valves and are often asymptomatic, but ☆systemic embolization (eg stroke, acute limb ischemia) can occur and the most common presentation of NBTE rheumatologyUWorld HirotoShishido
triggers/ treatment for Raynaud diseasecold temperature, stress, caffeine, nicotine, medication that affect sympathetic nervous system
common in pregnant woman or a job that requires vibration
(digital ulceration(severe ischemia) can be seen in secondary(syndrome))
calcium2+ channel blockers rheumatology HirotoShishido
color change in Raynaud phenomenonvasospasm cause ischemia(white)→hypoxia(blue)→reperfusion(red) rheumatology HirotoShishido
