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HD - SGPSS 9 (Autoimmune Disease)


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What are some symptoms of Graves' disease?
Termor, weight loss, enlarged thyroid, prominent eyes, high serum thyroid hormone levels, low to undetectable TSH levels.
How might the AIRE complex be involved with Graves' disease (or any other autoimmune disease?)
Self-antigen for the organ may not be present for the thyroid, so it will eventually get attacked by the immune system.
What is the mechanism behind Graves' disease?
An agonistic Ab is produced by autoreactive B-cells. Ab's bind to the TSH receptor or to TSH itself, hyperactivating TSH production (not destroying the gland).
How might the DNA of Graves' disease DNA be different from a normal one?
It might show an abnormal AIRE complex. Also, this might be mediated by abnormal CD4,25 T-reg cells that allow self-reactive CD3,4 cells escape the thymus.
How does diabetes develop by autoimmune disease?
Antibodies will somehow react destructively against the pancreas.
What is myasthenia gravis?
An autoimmune disease where auto-Ab's inhibit the ACh-R's, shutting down the neuromuscular junction. Peripheral tolerance for ACh-R has been lost, and Ab's are binding and inhibiting it. Probably due to CD4,25 T-reg deficiency (maybe AIRE also).
In the biopsy, why was there no inflammatory mediators or any other significant findings?
Because the constitutive activation of the receptor would downregulate it within minutes by endocytosis, and the inflammatory reaction would die out quickly.
What is celiac sprue?
Allergy to gluten (wheat products).
What is the mechanism behind celiac sprue?
Gluten is taken up by MHC II and presented in such a way that, due to a genetic defect in the D loci, results in a T-cell cytotoxic response against enterocytes of the small intestine.
Multiple autoantibodies were found in her serum. What information does this provide to the immunologist?
The auto-Ab is simply diagnostic of the condition, it is not the etiology.
What type of hypersensitivity disease is celiac sprue and why?
Type IV because it is really the result of a TMMI response, since the auto-Ab's generated are only diagnostic.
What are the symptoms for celiac sprue?
Diarrhea, bloating, weight loss, dehydration due to inflammation of the small bowel.

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