Autoimmune Disorders

Autoimmune Disorders

Classification of Autoimmune Diseases
Local single organ
Probable:

* Hashimoto thyroidistis
* Autoimmune haemolytic anaemia
* Autoimmune atrophic gastritis (pernicious anemia)
* Autoimmune encephalomyelitis
* Autoimmune orchitis
* Goodpasture syndrome
* Autoimmune thrombocytopaenia
* Type I DM (IDDM)
* Myasthenia gravis
* Graves disease

Possible:

* Primary biliary cirrhosis
* Chronic active hepatitis
* Ulcerative colitis
* Membranous glomerulonephritis

Systemic multiple sites

Probable:

* Systemic Lupus Erythematosus
* Rheumatoid arhtritis
* Sjogren’s syndrome
* Reiter syndrome
* Inflammatory myopathy
* Systemic sclerosis (scleroderma)
* Polyarteritis nodosa

Immunological Tolerance

* State in which an individual is capable of developing an immune response against a specific antigen
* Self- tolerance specifically refers to a lack of immune responsiveness to one’s own tissue antigens
* Immunologically competent cells learn to recognize the body’s own antigens at an early stage
* Central vs peripheral tolerance

Central Tolerance
Clonal deletion
Peripheral Tolerance
Apoptosis
Peripheral suppression
Failure in Tolerance

* Failure in activation-induced cell death (apoptosis)
* Breakdown of T-cell anergy
* Bypass of B-cell requirement for T-cell help
* Failure in T-cell mediated suppression
* Polyclonal lymphocyte activation
* Release of sequestered antigens
* Exposure of cryptic self & epitope speading
* Normally maintained in isolation from immune mechanisms
* Hidden/sequestered antigens may not be recognised as self (such as intracellular substances)
* E.g spermatazoa; myelin protein; lens material



Breakdown of T-cell helper tolerace
T-cell suppressor function
Genetics
Infection
Autoimmune Disorders & Mechanisms
General Pathology
Immunological Antibodies & HLA
Rheumatoid Factor
Antinuclear Antibody
Pansma autoantibodies & Disease Association
Human Leukocyte Antigen (HLA)
HLA – B27

Autoimmune Disorders.ppt

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Hyperaemia & Congestion

Hyperaemia & Congestion

Presentation contains:
Hyperaemia
Congestion
Physiological
Pathological
Congestion

* Congestion of capillary beds closely related to the development of oedema (congestion & oedema commonly occour together).
* Chronic passive congestion leads to hypoxia due to stasis of poorly oxygenated blood, resulting in parenchymal cell degeneration or death.
* Capillary rupture at sites of chronic congestion may cause small foci of haemorrhage.
* Breakdown & phagocytosis of red cell debris can result in small clusters of haemosiderin-laden macrophages.
Local Passive Venous Congestion:
Pathological Effects of Congestion
Pathological Effects of Congestion
Chronic Passive Venous Congestion of Spleen

Hyperaemia & Congestion.ppt

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The Haematopoietic & Lymphoid Systems

The Haematopoietic & Lymphoid Systems

Erythrocytes

* Haematocrit
* MCV - size of RBC
* MCH - Hb content
* MCHC - Hb content
* Anaemia - decreased RBC’s/Hb conc.
* Anisocytosis - variation in size
* Poikilocytosis - abnormal shape
* Polycythemia - increased RBC’s

Leukocytes

* Granulocytes - neutrophil; basophil; eosinophil
* Agranulocytes - lymphocytes; monocytes
* Leukocytosis - increased WBC’s
* Neutrophilia
* Monocytosis
* Eosinophilia
* Basophilia
* Lymphocytosis
* Leukopaenia - decresed WBC’s
* Neutropaenia
* Pancytopaenia
* lymphoaenia


Platelets

* Thrombocytopaenia
* Decreased platelets
* Thrombocytosis
* Increased platelets

Haemopoiesis

* Sites of Haemopoiesis
* Haemopoietic stem cells
* Erythropoiesis
* Leukopoiesis
* Megakaryocytopoiesis
* Blood cells kinetics
* Control of haemopoiesis
* Haemoglobin


Blood Cell Differentiation from Stem Cell

Haemopoiesis
Haemoglobin
Anaemia
Classification of Anaemia
RBC morphology

Haemorrhage & Blood Loss Anaemia
Iron-deficiency Anaemia
Mechanisms of Iron Deficiency
Iron Metabolism
Clinical Pathogenesis
Clinical Morphology & Features
Diagnostic Criteria
Megaloblastic Anaemia
Megaloblast

Fe accumulation in bone marrow
Affects granulocyte & platelet precursors
Pancytopaenia
Morphology
Vitamin B12 Deficiency Anaemia
Mechanisms of Deficiency
Vit B12
Folate Deficiency Anaemia
Anaemia of Chronic Disorders
Chronic inflam disease
Aplastic (hypoplastic) Anaemia
Aetiology
Pathogenesis
Myelopthisic Anaemia
Haemolytic Anaemia
Consequences of Haemolytic Anaemia
Immune Haemolyitic Anaemias
Hereditary Spherocytosis
Sickle Cell Anaemia
Haemoglobinopathy
Factors that influence sickling
Hereditary spherocytosis
Thalassemia
β-thalassemia
Thalassemia major
Thalassemia minor
Glucose-6-Phosphate Dehydrogenase Deficiency
Pyruvate Kinase Deficiency
Paroxysmal Nocturnal Haemoglobinuria
Immunohaemolytic Anaemias
Warm Ab Immunohaemolytic Anaemia
Cold Ab Immunohaemolytic Anaemia
Microngiopathic Haemolytic Anaemia
Malaria
Leukaemia
Acute Leukaemia
Chronic Leukaemia
Clinical Course
Chronic Lymphocytic Leukaemia (CLL)
Chronic Myeloid Leukaemia (CML)
Myelodysplastic Disorders
Myeloproliferative Disorders
Natural History of Myeloproliferative Disorders
Polycythaemia rubra vera
Common aetiological conditions & pathology
Myelofibrosis
Essential Thrombocythaemia
Plasma Cell Dyscrasias
Multiple Myeloma
Pathology of Bone Disease in MM
Disorders of Primary Haemostasis
Thrombocytopaenia (decreased platelets in blood due to excessive destruction or decreased production)
Idiopathic Thrombocytopaenic Purpura
Thrombotic Microangiopathies (disorders of small vessels resulting in thrombosis)
Thrombocytic Thrombocytopaenic Purpura
Fundamental to TTP & HUS
Immune Thrombocytopaenias
Acquired Disorders of Platelet Function
Bleeding Due to Vascular Disorders
Henoch-Schonlein Purpura
Disorders of Blood Coagulation
Haemophilia (inherited disorder in which the blood clots very slowly due to deficiency of clotting factors)
Von Willebrand Disease
Disseminated Intravascular Disease
Aetiological factors
Haemorrhage & ischaemia

The Haematopoietic & Lymphoid Systems.ppt

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