RHEUMATOID ARTHRITIS RA RA is a chronic systemic
- Slides: 27
RHEUMATOID ARTHRITIS (RA)
RA is a chronic, systemic inflammatory disorder of unknown etiology characterized by the manner in which it involved joints Progressive joint destruction variable degrees of incapacitation F: M=2 -3: 1 40 -60 years old and deformity leads to
Etiology Genetic factors: Infection HLA-DR 4
Etiology Rheumatoid factors (RF) are antibodies with specificity for antigenic determinates on the Fc portion of human or animal Ig. G. Currently, the most popular notion that RF arise as antibodies to “altered” autologous Ig. G
Clinical features The onset of RA is frequently heralded by prodromal symptoms such as fatigue, anorexia, weight loss, weakness and generalized aching and stiffness Joint disease Extraarticular manifestations
Xerostomia (Dry Mouth) Xerophthalmia (Dry Eyes)
Rheumatoid Vasculitis RA Deformities
Laboratory Tests for RA
Laboratory findings Anemia of moderate degree ESR a useful parameter for assessing response to therapy C-reactive protein RF (usually Ig. M) CIC , complements ANA Anti-CCP (cyclic citrullinated peptide)
Rheumatoid Factor § Antibodies to Fc portion of Ig. G § 75 -80% of Patients have during course of disease § Useful for prognosis
Rheumatoid Factor Ig. G Molecule Fc Portion Autoantibodies (Ig. M) directed against the Fc Fragment of Ig. G Antigen Binding Groove An Antibody to an Antibody Their Role in RA is not understood
Rheumatoid Factor RFs are human auto-Abs that react with the Fc portion of normal polyclonal Ig. G. Most routine clinical assays for RF detect only Ig. M RFs, although RFs can be any class of immunoglobulin Named thus because their first description was in patients with rheumatoid arthritis
Rheumatoid Factor RF test is approximately 65%-75% sensitive for the diagnosis The presence of RF, even in high titers or large amounts, is not specific for RA
Condition Associated With (+) Tests for RF Rheumatologic Diseases Rheumatoid arthritis (~70%) Sjögren’s syndrome (~90%) Lupus (~20%) Cryoglobulinemia syndrome (90%) Lung Diseases Interstitial fibrosis Silicosis Infections Hepatitis C virus Acute viral infections Endocarditis Tuberculosis Miscellaneous Sarcoidosis Malignancies Aging
Methods for detection FR Agglutination (latex) ELISA RIA Torbidometry Nephlometry
Agglutination Definition: the clumping together of antigen bearing cells, microorganisms or particles in the presence of specific antibodies Particles may be RBCs (hemagglutination), bacterial cells (coagglutination) or inert particles such as latex or charcoal coated with antigen or antibody
Agglutination Reactions Advantages: Easy to carry out No complicated equipment needed Can be performed as needed Available in pre-package kits with controls Reactions are QUALITATIVE, i. e. , positive or negative Titers can be performed to give semi-quantitative results
Agglutination (The Antigen is a Partiulate)… Qualitative: Slide Agglutination Tasts Semi Quantitative: Tube Agglutination Tests Qualitative: Primary Reaction (ELISA, …)
Slide Test Agglutination -- Qualitative Method �Latex agglutination
Tube Test Agglutination -- Semi Quantitative Method Tube Agglutination Tests: Identify & Titrate antibodies in the patient’sserum. Titre: is defined as the reciprocal of the highest dilution of serum showing agglutination. 1/100 1/200 1/400
Passive Agglutination �Converting a precipitating test to an agglutinating test �Chemically link soluble antigen to inert particles such as LATEX or RBC �Addition of specific antibody will cause the particles to agglutinate �Reverse PAT: antibody linked to LATEX e. g. Lancefield grouping in Streptococci.
Passive Agglutination- Rheumatoied Factor (Ig. M) Latex Human Ig. G (Intact Ab)
Reverse Passive Agglutination- CRP Latex Anti CRP-Ab
ELISA Quantitative Method
- Caplan syndrome
- Soft tissue rheumatoid arthritis
- Barik meaning
- Steinbrocker stage
- Extra articular manifestations of rheumatoid arthritis
- Fibula fractire
- Rheumatoid arthritis side effects
- What is esr
- Rheumatoid arthritis
- Ocular sign
- Nursing diagnosis for rheumatoid arthritis
- Pauciarticular juvenile rheumatoid arthritis
- Rheumatoid arthritis
- Rheumatoid nodules
- Site:slidetodoc.com
- Rheumatoid factor range
- Septic arthritis antibiotics
- Kode icd 10 fraktur coccygeus
- Psoriasis arthritis nhs
- Seronegative arthritis
- Caprine arthritis encefalitis
- Boutonniere nodes
- Rheumatisches granulom
- Reactive arthritis pathophysiology
- Zveren
- Diabetes and allergies
- Septic arthritis antibiotics
- Gardening with arthritis