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There are more than 100 different types of autoimmune diseases, affecting more than 50 million people

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There are more than 100 different types of autoimmune diseases, affecting more than 50 million people. Examples of the more common types of autoimmune diseases appear in Table 53.1.4 Omitted from this chapter are specific details concerning three particular autoimmune diseases (immune-mediated diabetes mellitus, rheumatic heart disease, and acquired immunodeficiency syndrome) because these conditions are discussed in other chapters of this text. A description of signs and symptoms reflecting major system involvement of various autoimmune diseases is found in Table 53.2.4 TABLE 53.1 th autoimmune mune complexes z observed with wo ways. First, -antigens, which nune complexes c involvement, e. without directly zceptor function ne receptors are sing paralysis of odies stimulate normone. This is ate thyroid cells Examples of Autoimmune Diseases Autoimmune Disease Definition Adrenal insufficiency Primary condition is known as Addison disease, which is caused by destruction of the adrenal glands from infections, cancer, or chronic use of steroid hormones Secondary adrenal insufficiency is caused most often by chronic use of steroids Adrenal crisis is a life-threatening condition caused by acute adrenal suppression A benign chronic blistering disease affecting the oral and genital mucosa, conjunctiva of the eye, skin; characterized by healing of disease may be presenting with Cicatricial pemphigoid multiple organs; better known as systemic sclerosis Sjögren syndrome A triad of keratoconjunctivitis sicca, xerostomia, and connective tissue disorder manifesting as a wide spectrum of severity. Includes primary and secondary forms Systemic lupus A disease in which injury is caused mainly by deposition of immune erythematosus complexes and binding of antibodies to various cells and tissues; affects major organ systems, characterized by periods of remissions and exacerbations TABLE 53.2 Signs and Symptoms of Major System Involvement of Autoimmune Diseases System Constitutional Musculoskeletal lesions with scarring Fibromyalgia A widespread musculoskeletal disorder characterized by pain in the muscles, ligaments, and joints, and fatigue. Has a frequent comorbidity with other autoimmune conditions including chronic fatigue syndrome, rheumatoid arthritis, systemic lupus erythematosus, and hypothyroidism Hyperthyroidism Also known as thyrotoxicosis, an excess of thyroxine (T4) and triiodothyronine (T) in the bloodstream, affecting the body's metabolic rate. Primary is used to designate hyperthyroidism arising from an intrinsic thyroid abnormality. Secondary is used to designate that arising from processes outside of the thyroid, such as TSH- secreting pituitary tumor Hypothyroidism Structural or functional derangement that interferes with the production of thyroid hormone (e.g., autoimmune thyroiditis, congenital hypothyroidism, iatrogenic hypothyroidism-surgical or radiation-induced ablation). Multiple sclerosis The most common autoimmune disease affecting the nervous system, characterized by demyelination of nerves in the central nervous system because of chronic inflammation Myasthenia A chronic autoimmune disease that affects the neuromuscular system gravis representing a decrease in acetylcholine receptors in muscle fibers, resulting in progressive fatigability and abnormality of skeletal muscles Pemphigus A progressive, severe disease affecting the skin and mucous vulgaris membranes characterized by bullae that rupture and form painful ulcers Pemicious anemia Failure of the stomach to produce intrinsic factor and lack of cobalamin, or vitamin B12 Psoriasis Chronic inflammatory dermatosis characterized by well-demarcated pink to salmon-colored plaques covered by loosely adherent silver- white scales on the surface of lesions; approximately 15% is associated with arthritis (psoriatic arthritis) Rheumatoid A chronic inflammatory condition principally attacking the joints and arthritis producing a nonsuppurative proliferative and inflammatory synovitis characterized by pain, swelling, stiffness, and loss of function. Scleroderma A chronic disease of connective tissue secondary to vascular injury and progressive interstitial and perivascular fibrosis of the skin and Skin Renal Features Fatigue, fever in the absence of infection, weight loss/gain, difficulty sleeping, cold or heat intolerance Arthralgia, myalgia, arthritis, joint pain and swelling, loss of joint range of motion, carpal tunnel syndrome, flexion contractures, muscle weakness, diaphoresis, tremors, warm/flushed skin Photosensitivity, diffuse rash, skin lesions or nodules, mucous membrane lesions, purpura, alopecia, Raynaud phenomenon, urticaria, vasculitis, skin pigment changes, skin tightness and induration, telangiectasis, calcinosis, edema, thin/fine hair, soft or brittle nails Hematuria, proteinuria, casts, nephritic syndrome, renal crisis or failure Nausea, vomiting, gastroparesis, abdominal pain, peritonitis with or without ascites, hepatomegaly, pancreatitis, gastroesophageal reflux disease, dysphagia, dyspepsia, diarrhea alternating with constipation, candidiasis, primary biliary cirrhosis, malabsorption, diverticula Pleurisy, pleural effusion, chest pain, shortness of breath, pulmonary parenchyma, pulmonary hypertension, cough from restrictive lung disease Pericarditis, noninfective endocarditis, myocarditis, chest pain, arrhythmia, valve abnomalities, myocardial infarction, congestive heart failure, myocardial fibrosis, palpitations, Gastrointestinal Pulmonary Cardiovascular