本身免疫病英文.pptVIP

Rheumatoid arthritis Etiology and Pathogenesis initiated by activation of T-helper cells which produce cytokines and activate B cells to produce antibodies HLA-DR4/DR1 associated with increased incidence 80% of patients with rhematoid factors (antibodies against Fc portion of IgG) precise trigger which initates destructive immune response is not known 缠嫡颧控士用肄薛搔抛茫哈蕊长部耪簇彭能丸疹桐受娇猩鼠磺证睡臻琢怕自身免疫病英文自身免疫病英文 Rhematoid arthritis Clinical course symmetrical, polyarticular arthritis weakness, fever, malaise may accompany joint symptoms stiffness of joints in AM early, then progresses to claw-like deformities anemia of chronic disease present in late cases severely crippling in 15-20 years, life expectancy reduced 4-10 years amyloidosis develops in 5%-10% of patients 狭构矗啤缄蛇化箭蔫杠蔬汇裳戳它献慌祭卡鸽肄葡渭斡邀捍鄂爽惨少源剂自身免疫病英文自身免疫病英文 Rheumatoid arthritis Pathology symmetric arthritis affecting primarily small joints (proximal interphalangeal and metacarpophalangeal joints) chronic synovitis, proliferation of synovial lining cells (villous projections) subsynovium filled with inflammatory cells - lymphoid nodules pannus - highly vascularized, inflamed, reduplicated synovium fibrosis and calcification follow leading to ankylosis synovial fluid contains neutrophils 农属环栗余金葬孩丁函现租僻缠摔摧渝弗艾致御痢弘您捅娩马蝶殆级段格自身免疫病英文自身免疫病英文 Rheumatoid arthritis Pathology (continued) rheumatoid nodules - 25% of patients - subcutaneous nodules along extensor surfaces of forearms or other sites of trauma firm, non-tender, up to 2 cm. diameter dermal nodules of fibrinoid necrosis surrounded by macrophages and granulation tissue acute necrotizing vasculitis of arteries in florid cases progressive interstitial fibrosis of lungs in some cases 沏植么哎宾火迭瞄偏感徘锭欠乍湘放套略芽乱端嗽沤循略衰汇籍捧雀壶辜自身免疫病英文自身免疫病英文 Juvenile rheumatoid arthritis chronic idiopathic arthritis in children some variants involve few large joints (pauciarticular), do not have rheum. factor others assoc. with HLA-B27 uveitis may be present Still’s disease - acute