Systemic Lupus Erythematosus and Rheumatoid arthritis 醫學一 B 王樂詠 B 許伊婷

Systemic autoimmune disease the immune system attacks human’s body itself Examples: Systemic lupus erythematosus(SLE or lupus), Rheumatoid arthritis(RA), Scleroderma and Systemic sclerosis (or systemic scleroderma), Dermatomyositis (DM) and Sjögren's syndrome

Systemic Lupus Erythematosus Systemic autoimmune disease Type III hypersensitivity reaction caused by antibody-immune complex formation When attacking body’s cell and tissue, it results in inflammation. Occurs more often in women Fatal, currently no cure

Causes Genetics: Human leukocyte antigen(HLA, located on chromosome 6), IRF5, PTPN22, STAT4, CDKN1A, ITGAM, BLK, TNFSF4 and BANK1 Environmental triggers: ex. silicone gel- filled breast implants Drug reactions: procainamide, hydralazine, quinidine, and phenytoin

Pathophysiology

Treatment Medications: Disease-modifying antirheumatic drugs, Immunosuppressive drugs, Analgesia, Intravenous Immunoglobulins (IVIGs) Lifestyle changes Renal transplantation Hughes syndrome

Rheumatoid arthritis An autoimmune disease, causes inflammation of the joints Rheumatoid arthritis can affect multiple other organs of the body; and is referred to as a systemic illness.

Causes The reason triggers the RA is unknown. Inherited: people with a gene of HLA-DR4/DR19 are tend to have the disease (Chinese 0.4% ， Caucasoid 1%) Infection: an infection triggers an immune response, and the antibody attack joins and organs due to the mistaken identity. Environmental factors : smoking tobacco increases the risk of developing rheumatoid arthritis. Immune system be geared; lymphocytes and cells of synovium release cytokine and chemokine in the inflamed areas. Cause serious inflammation and damage bones and cartilage.

Symptom Joints become swollen, tender, warm and stiff. Inflames multiple joints in a symmetrical pattern, most commonly small joints of the hands and feet, like wrists and knuckles. Disease alternates between the relapse and remission stage. Antibodies with high concentration cause extra-articular diseases.

Diagnose & Treatment Find the presence of antibodies to citrullinated peptides, which can test the disease at the early stage. No known cure for RA. "first-line drugs": aspirin and cortisone, are used to reduce pain and inflammation. "second-line drugs“: slower, such as DMARDs and methotrexate, preventing progressive joint destruction, but not anti-inflammatory agents. Treatment also includes rest and physical activity.

Comparison LupusRheumatoid arthritis CauseGenetics, Environmental triggers, Drug reactions Genetics, Infection, Environmental factor EffectSkin, Joint, Kidney, Brain, Heart and Lung Joint, Lung, Skin, Nerve, Muscle Trend of activity of the disease in the body Can be controlled by medicine, still being weakening Disease alternates between the relapse and remission stage, in different people will have different condition. Life-threateningOX Chances of survivalXX

參考資料 tw/%E9%A1%9E%E9%A2%A8%E6%BF%95%E6%80%A7%E9%9 7%9C%E7%AF%80%E7%82%8E tw/%E9%A1%9E%E9%A2%A8%E6%BF%95%E6%80%A7%E9%9 7%9C%E7%AF%80%E7%82%8E 認識類風溼性關節炎.pdf 認識類風溼性關節炎.pdf