Systemic Lupus Erythematosus and Rheumatoid arthritis

醫學一 B9902009 王樂詠 B9902044 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.

ComparisonLupus Rheumatoid arthritis

Cause Genetics, Environmental triggers, Drug reactions

Genetics, Infection, Environmental factor

Effect Skin, 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-threatening O X

Chances of survival X X

參考資料• http://en.wikipedia.org/wiki/Systemic_lupus_erythematosus• http://en.wikipedia.org/wiki/Systemic_autoimmune_disease• http://en.wikipedia.org/wiki/Rheumatoid_arthritis#Joints• http://zh.wikipedia.org/zh-tw/%

E9%A1%9E%E9%A2%A8%E6%BF%95%E6%80%A7%E9%97%9C%E7%AF%80%E7%82%8E

• http://www.lai-obs.com/sbb/page9a.htm• http://beaver.dlc.ncnu.edu.tw/projects/emag/article/200607/認識類風溼性關節炎 .pdf