Connect-Tissue-200002

Connect-Tissue-200002 - Connective Tissue Diseases Edward...

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Unformatted text preview: Connective Tissue Diseases Edward D. Buckingham, MD Byron J. Bailey, MD Introduction collagen vascular diseases, autoimmune diseases knowledge of immune system difficult to diagnose nonspecific symptoms tend to overlap common histiologic feature inflammatory damage CT and blood vessels fibrinoid material deposition Immune System lymphoid stem cell B-cell T-cell macrophage or monocyte NK cells Connective Tissue Diseases abnormal interaction three theories sequestered antigen exogenous antigen altered antigen Systemic Lupus Erythematosus General autoimmune multisystem disease prevalence 1 in 2,000 9 to 1; female to male (1 in 700) peak age 15-25 immune complex deposition photosensitive skin eruptions, serositis, pneumonitis, myocarditis, nephritis, CNS involvement Systemic Lupus Erythematosus specific labs - native(Double stranded) DNA, SM antigen lupus like reaction(procainamid e, hydralazine, ect) LE cells SLE - Diagnostic Criteria SLE Head and Neck Manifestations Malar rash first sign in 50% Erythematous maculopapular eruption after sun exposure Oral ulceration SLE SLE Head and Neck Manifestations 3-5% perforated nasal septum larynx and trachea involvement rare TVC thickening, paralysis, cricoarytenoid arthritis, subglottic stenosis acute parotid enlargement 10% SLE Head and Neck Manifestations xerostomia occas neuropathy 15% discoid lupus SLE Treatment avoid sun exposure NSAIDS topical and systemic steroids antimalarials low-dose methotrexate azothioprine, cyclophosphamide restricted symptomatic treatment saliva substitutes, Klacks solution postprandial rinses with H2O2 and H2O Rheumatoid Arthritis General synovial tissue involvement symmetric peripheral joints (hands, feet, wrists) RA General nonarticular muscular structures tendon, ligament, fascia systemic disease occas. vasculitis, pulmonary fibrosis pathogenosis inflammatory cell infiltrates synovial proliferation HLA Dw4 RA General prevalence 1% of population 2-3 times F>M 4th and 5th decade signs and symptoms morning stiffness lasting greater than 30 min sub-Q rheumatoid nodules synovial fluid inflammation 2K - 75K 50% PMNs RA General diagnosis based on clinical grounds labs RF pos. in 12 months 90% RA associated nuclear antigen (RANA) anti-RA-33 RA Head and Neck Manifestations TM joint 55% symptomatic 70% incidence on X- ray juvenile RA - micrognathia RA Head and Neck Manifestations cricoarytenoid joint most common cause of arthritis 30% patients hoarse 86% pathologic involvement exertional dyspnea, ear pain, globus hoarseness rheumatoid nodules, recurrent nerve involvement stridor local/systemic steroids poss. Tracheotomy RA...
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This note was uploaded on 01/02/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Connect-Tissue-200002 - Connective Tissue Diseases Edward...

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