Systemic Lupus Erythematosus
|
|
- Nora McDowell
- 7 years ago
- Views:
Transcription
1 Systemic Lupus Erythematosus
2 Definiton and Prevalence Autoimmune disease Organs and cells damage Tissue-binding autoantibodies and immune complexes 90% women of child-bearing years cases/100,000
3 Pathogenesis and Etiology Susceptibility genes - environment interactions abnormal immune responses pathogenic autoantibodies+immune complexes deposit in tissue activate complement inflammation irreversible organ damage Multigenic disease: HLA-D2,3,8 Region on chromosome 16 contains genes that predispose Female sex Estrogen-containing oral contraceptives
4 Pathogenesis and Etiology2 Environmental factors: exposure to ultraviolet light, EBV can trigger Geneticsusceptibility+environment+sex abnormal immune responses autoimmunity
5
6 Pathology Renal biopsy pattern and severity of injury diagnosis best therapy Class III, IV, V disease aggressive immunosuppression Class I, II,VI no treatment Leukocytoclastic vasculitis in SLE
7 Classification of Lupus Nephritis (LN) Class I: Minimal Mesangial LN Class II: Mesangial Proliferative LN Class III: Focal LN Class IV: Diffuse LN Class V: Membranous LN Class VI: Advanced Sclerotic LN
8 Diagnostic criteria for SLE 1. Malar rash: fixed erythema, flat or raised, over the malar eminences 2. Discoid rash: erythematous circular raised patches with adherent keratotic scaling and follicular plugging 3. Photosensitivity: exposure to ultraviolet light causes rash 4.Oral ulcers: includes oral and nasopharyngeal ulcers, observed by physician
9
10 Diagnostic criteria for SLE Arthritis: nonerosive arthritis of two or more peripheral joints, with tenderness, swelling, or effusion 6. Serositis: pleuritis or pericarditis documented by ECG or rub or evidence of effusion 7. Renal disorder: proteinuria > 0,5 g/d or 3+, or cellular casts
11
12 Diagnostic criteria for SLE Neurologic disorder: seizures or psychosis without other causes 9. Hematologic disorder: hemolytic anemia or leukopenia (<4000/μL) or lymphopenia (<1500/μL) or thrombocytopenia (<100,000/μL) in the absence of offending drugs 10. Immunological disorder: anti-dsdna, anti-sm, and/or anti-phospholipid
13 Diagnostic criteria for SLE Antinuclear antibodies: an abnormal titer of ANA by immunofluorescence or an equivalent assayat any point in time in the absence od drugs known toinduce ANAs If 4 of these 11 criteria, well documented, are present at any time in a patient s history, the diagnosis is likely to be SLE.
14 Autoantibodies in SLE ANA (Antinuclear antibodies): prevalence 98%, best screening test, repeated negative tests make SLE unlikely Anti-dsDNA: prevalence 70%, high titers are SLE-specific, and is some patients correlate with disease ctivity, nephritis, vasculitis Anti-Sm: prevalence 25%,, specific for SLE, no definite clinical correlations
15 Autoantibodies in SLE 2. Anti-RNP: prevalence 40%, not specific for SLE, high titers associated with overlap syndromes Anti-Ro (SS-A): prevalence 30%, not specific for SLE, associated with sicca syndrome, subacute cutaneous lupus, and neonatal lupus with congenital heart block Anti-La (SS-B): prevalence 10%,
16 Autoantibodies in SLE 3. Antihistone: prevalence 70%, more frequent in drug-induced SLE Antiphospholipid: prevalence 50%, predisposes to clotting, fetal loss, thrombocytopenia Antineuronal (includes anti.glutamate receptor): prevalence 60%, correlates with active CNS lupus Antiribosomal P: prevalence 20%, correlates with depression or psychosis due to CNS lupus
17 Diagnosis of SLE Characteristic clinical features + autoantibodies The presence of multiple autoantibodies without clinical symptoms no SLE Establish the severity and potential reversibility of SLE
18 Systemic manifestations Fever Weight loss Anemia Fatigue Myalgia/arthralgias
19
20 Musculoskeletal manifestations Polyarthritis: hands, fingers, wrists, knees Erosions on joint x-rays: rare Myalgias without frank myositis Steroid theapy muscle weakness
21 Cutaneous manifestations DLE: discoid lupus erythematosus Systemic rash SCLE: subacute cutaneous lupus erythematosus Circular discoid lesions on the face and scalp Rash photosensitive on the face cheeks and nose butterfly rash,chin, V region of the neck, upper back
22 Renal manifestations Lupus nephritis Urinalysis: microscopic hematuria, proteinuria >500 mg/24 h Nephrotic syndrome Secondary hypertension Accelerated atherosclerosis
23 Nervous system manifstations Headaches Seizures Psychosis Myelopathy
24 Vascular occlusions Antiphospholipid Ab-s Acute thrombotic events Brain vasculitis Accelerated atherosclerosis AMI
25 Pulmonary manifestations Pleuritis Pleural effusion Pulmonary infiltrates on imaging Interstitial inflammation fibrosis Intraalveolar hemorrhage
26 Cardiac manifestations Pericarditis tamponade Myocarditis Fibrinous endocarditis of Libman- Sacks embolic events, mitral/aortic valvular insufficiencies Increased risk for AMI
27 Hematologic manifestations Anemia Hemolysis Leucopenia Lymphopenia Thrombocytopenia
28 Gastrointestinal manifestations Nausea, vomiting Diarrhea Diffuse abdominal pain autoimmune peritonitis, intestinal vasculitis Active SLE AST ALT
29 Ocular manifestations Sicca syndrome= Sjögren s syndrome Nonspecific conjunctivitis Retinal vasculitis Optic neuritis blindeness Steroids cataracts, glaucoma
30 Laboratory tests Establish the diagnosis Rule out the diagnosis Follow the course of disease Identify adverse effects of therapies
31 Tests for autoantibodies ANA ANA-negative lupus Anti-dsDNA Anti-Sm antibodies ACLA (anticardiolipin antibodies) APS (antiphospholipid antibody syndrome)
32 Tests for following disease course Anti-dsDNA C3 complement
33 Treatment of SLE No cure for SLE Control acute, severe flares Maintenance therapy suppress symptoms: 5 to 10 mg Prednisone per day Prevention of organ damage
34 Treatment of SLE 2. Glucocorticoids/steroids: oral Prednisone 0,5-1 mg/kg/day for severe disease Methylprednisolone: iv. lupus nephritis 1000 mg iv. for 3 days Cyclophosphamide: iv mg/kg/month x6 or oral mg/kg/day Azathioprine: oral 2-3 mg/kg/day
35 Treatment of SLE 3. Hydroxychloroquine: oral mg/day Mycophenolate mofetil: oral 2-3 g/day Methotrexate: oral mg once week Topical glucocorticoids NSAIDs
36 Life-threatening SLE: Proliferative forms of lupus nephritis 1000 mg Methylprednisolone iv. daily for 3 days response begin 24 h Cyclophosphamide iv mg/m 2 monthly for 3-6 months, then Azathioprine or Mycophenolate mofetil Responses begin -16 weeks after treatment Mycophenolate mofetil Cyclosporine: oral 3-5 mg/kg/day
37 Lupus and Antiphospholipid Antibody Syndrome Venous or arterial clotting Repeated fetal loss 2 positive est for antiphospholipids Therapy: long-term anticoagulation INR 2-3 recommended
38 Patients outcomes, prognosis, and survival Survival: 95% at 5 years, 90% at 10 years, 78% at 20 years
39 Drug-induced lupus Procainamide Propafenone Hydralazine ACE-inhibitors (Enalapril) Beta blockers Propylthiouracil Chlorpromazine Lithium Carbamazepine, Phenytoin Isoniazid Sulfasalazine Simvastatin, Lovastatin Interferons, TNF inhibitors
40 Sjögren s syndrome Definition: chronic, slowly progressive autoimmune disease Lymphocytic infiltration of the exocrine glands xerostomia and dry eyes Malignant lymphoma Primary and secondary forms Middle-aged women Prevalence: %
41 Pathogenesis T cell lymphocytic infiltration of the exocrine glands salivary gland enlargement B lymphocyte hyperreactivity Monoclonal immunoglobulins Anti-Ro/SS-A,anti-La/SS-B Abs Antibodies to α-fodrin (salivary glandspecific protein)
42 Clinical manifestations Diminished lacrimal and salivary gland function Mucosal dryness = xerostomia Difficulty in swallowing dry food Pnrease in dental caries, problems in wearing complete dentures Dry, sticky oral mucosa Saliva from the major glands not expressible Enlargement of the parotid
43
44 Clinical manifestations 2. Diagnotic tests: sialography, scintigraphy, sialometry Labial minor salivary gland biosy focal lymphocytic infiltrates Keratoconjunctivitis sicca Measurement of tear flow by Schirmer s test Decrease in mucous gland secretion of the upper and lower respiratory tree Atrophic gastritis Dy skin and external genitalia
45 Extraglandular manifestations Arthralgias/arthritis Raynaud s phenomenon Lympadenopathy Lung involvement Vasculitis Kidney involvement interstitial nephritis Liver involvement Lymphoma Anemia, ESR
46 Diagnosis 1. Ocular symptoms: dry eyes, use of arteficial tear 2. Oral symptoms: dry mouth, swollen salivary glands, frequent liquid drinking 3. Ocular signs: positive Shirmer s test 4. Histopathology: in minor salivary glands focal lymphocytic sialodenitis
47 Diagnosis Objective evidence of salivary gland involvement: parotid sialography, salivary scintigraphy, decreased salivary flow (<1.5 ml in 15 min) 6. Antibodies in the serum to Ro/SS-A or La/SS-B antigens, or both Dg: any 4 of the 6 items, or any 3 of the 4 objective criteria items
48 Treatment Symptomatic relief Arteficial tears: Liquifilm, 0.5% Methylcellulose, Hypo Tears Antidepressants, diuretics should be avoided decrease salivary and lacrimal secretion Xerostomia: fluid Pilocarpine 5mg 3x daily stimulate secretions
49
Systemic Lupus Erythematosus
Harvard-MIT Division of Health Sciences and Technology HST.021: Musculoskeletal Pathophysiology, IAP 2006 Course Director: Dr. Dwight R. Robinson Systemic Lupus Erythematosus A multi-system autoimmune
More informationCurrent issues in the Diagnosis and Management of Sjogren s Syndrome
Current issues in the Diagnosis and Management of Sjogren s Syndrome Robert I. Fox, MD., Ph.D. Scripps Memorial Hospital And Research Institute La Jolla, CA bobfox@adnc.com Primary Sjogren A systemic autoimmune
More informationRheumatology Labs for Primary Care Providers. Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine
Rheumatology Labs for Primary Care Providers Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine Objectives Review the Indications for and Interpretation of lab testing for the following diseases:
More informationSystemic Lupus Erythematosus Overview. Clinical presentation, pathophysiology, and therapeutic strategies over the course of disease
Systemic Lupus Erythematosus Overview Clinical presentation, pathophysiology, and therapeutic strategies over the course of disease Systemic Lupus Erythematosus (SLE) An inflammatory, multisystem, autoimmune
More information800-475-6473. www.sjogrens.org. www.sjogrens.org
S j ö g r e n s F a s t F a c t s l The hallmark symptoms of Sjögren s syndrome are dry eyes and dry mouth. l Sjögren s is one of the most prevalent autoimmune disorders, striking as many as 4,000,000
More informationCorporate Medical Policy
Corporate Medical Policy Serum Biomarker Panel Testing for Systemic Lupus Erythematosus File Name: Origination: Last CAP Review: Next CAP Review: Last Review: serum_biomarker_panel_testing_for_systemic_lupus_erythematosus
More informationSystemic Lupus Erythematosus
Systemic Lupus Erythematosus by Erik Letko, M.D. Boston, MA Case report A 54-year old Caucasian woman was admitted to the Massachusetts General Hospital for renal failure and changes in mental status.
More informationLupus in Children and Teenagers. Arielle Hay, MD Pediatric Rheumatologist Nicklaus Children s Hospital
Lupus in Children and Teenagers Arielle Hay, MD Pediatric Rheumatologist Nicklaus Children s Hospital Systemic Lupus Erythematosus (SLE) Chronic Illness What is lupus? Autoimmune Multisystem Antinuclear
More informationThe ANA Test: All You Need to Know Department of Family and Community Medicine Family Medicine Update April 25, 2014
The ANA Test: All You Need to Know Department of Family and Community Medicine Family Medicine Update April 25, 2014 Celso R. Velázquez MD Division of Rheumatology University of Missouri velazquezc@health.missouri.edu
More informationNURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response
NURS 821 Alterations in the Musculoskeletal System Margaret H. Birney PhD, RN Lecture 12 Part 2 Joint Disorders (cont d) Rheumatoid Arthritis Definition: Autoimmune disorder occurring in genetically sensitive
More informationRHEUMATOID ARTHRITIS ASSOCIATED SCLERITIS
RHEUMATOID ARTHRITIS ASSOCIATED SCLERITIS FEHMA TUFAIL M.D Case Report A 77-year-old white male presented with a history of painful, red right eye. The patient was diagnosed with mild iritis in the right
More informationSF-DCT INFORMATION FOR PRIMARY SJOGREN S SYNDROME (PSS) CLAIMS OPTION 1. (PSS claims are not eligible for Disease Option 2)
SF-DCT INFORMATION FOR PRIMARY SJOGREN S SYNDROME (PSS) CLAIMS OPTION 1 (PSS claims are not eligible for Disease Option 2) 1 Primary Sjogren s Syndrome (PSS) Sjogren s Syndrome (SHOW-grins) is an autoimmune
More informationSARCOIDOSIS. Signs and symptoms associated with specific organ involvement can include the following:
SARCOIDOSIS Sarcoidosis is a disease that occurs when areas of inflammation develop in different organs of the body. Very small clusters of inflammation, called granulomas, are seen with sarcoidosis. They
More informationArthritis and Rheumatology. Antoni Chan MBChB, FRCP, PhD Consultant Rheumatologist Royal Berkshire NHS Foundation Trust
Antoni Chan MBChB, FRCP, PhD Consultant Rheumatologist Royal Berkshire NHS Foundation Trust Rheumatology Investigation, Diagnosis, Treatment The challenge 8 billion a year in cost 700,000 people suffering
More informationDisclosures. None. Seth Compton, MD Fellow of Rheumatology University of Mississippi Medical Center. Thank you for coming
Disclosures None Seth Compton, MD Fellow of Rheumatology University of Mississippi Medical Center Steroids Steroids Thank you for coming 1 Outline Osteoarthritis Rheumatoid Arthritis Monoarthritis Systemic
More informationPRACTICAL HELP FROM THE ARTHRITIS FOUNDATION. www.arthritis.org 800-283-7800. Sjögren s Syndrome
Sjögren s Syndrome WHAT IS SJÖGREN S SYNDROME? Sjögren s (SHOW-grens) syndrome is an autoimmune disease that causes dryness, particularly of the eyes and mouth. In autoimmune diseases (auto means self
More information(Intro to Arthritis with a. Arthritis) Manager of Education & Services for the Vancouver Island Region of The Arthritis Society
Arthritis 101 (Intro to Arthritis with a Focus on Rheumatoid Arthritis) by Cari Taylor by Cari Taylor Manager of Education & Services for the Vancouver Island Region of The Arthritis Society What You Will
More informationSF-DCT INFORMATION FOR SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) CLAIMS OPTIONS 1 & 2
SF-DCT INFORMATION FOR SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) CLAIMS OPTIONS 1 & 2 1 Systemic Lupus Erythematosus (SLE) Systemic Lupus Erythematosus (SLE) is a condition of chronic inflammation when the body
More informationLUPUS. and Light Sensitivity LUPUSUK 2015
15 LUPUS and Light Sensitivity LUPUSUK 2015 LUPUS and Light Sensitivity Systemic lupus erythematosus (SLE or lupus) is a multisystem disease with a tendency to cause skin rashes. These often appear on
More informationSystemic Lupus Erythematosus and Related Syndromes Robert G. Lahita, MD, PhD
Systemic Lupus Erythematosus and Related Syndromes Robert G. Lahita, MD, PhD Contents 1. Systemic Lupus Erythematosus 2. Antiphospholipid Syndrome 3. References SYSTEMIC LUPUS ERYTHEMATOSUS AND RELATED
More informationManagement in the pre-hospital setting
Management in the pre-hospital setting Inflammation of the joints Two main types: Osteoarthritis - cartilage loss from wear and tear Rheumatoid arthritis - autoimmune disorder Affects all age groups,
More informationPATIENT HISTORY FORM
PATIENT HISTORY FORM If you are new to the office, have not been seen in over one (1) year, or are returning for a new problem, please complete this form in full. If there have been any changes since your
More informationRheumatoid Arthritis. GP workshop 15 January 2011
Rheumatoid Arthritis GP workshop 15 January 2011 Case 1 A 72 year old Malay woman with RA comes for routine follow up. She feels generally unwell in the last 5 days. Appetite is fair. Her joints are fine.
More informationLCD for Erythrocyte Sedimentation Rate (ESR)
LCD for Erythrocyte Sedimentation Rate (ESR) Applicable CPT Code(s): 85651 Sedimentation Rate, Erythrocyte; Non-Automated 85652 Sedimentation Rate, Erythrocyte; Automated ICD-9 Codes that Support Medical
More informationRheumatoid arthritis: an overview. Christine Pham MD
Rheumatoid arthritis: an overview Christine Pham MD RA prevalence Chronic inflammatory disease affecting approximately 0.5 1% of the general population Prevalence is higher in North America (approaching
More informationDAVID R. MANDEL, M.D., INC. Rheumatologist
DAVID R. MANDEL, M.D., INC. Rheumatologist 2011 NEW THERAPIES IN RHEUMATOID ARTHRITIS AND OSTEOPOROSIS CLINICAL MANIFESTATIONS Rheumatoid arthritis is a chronic systemic autoimmune disease that affects
More informationPsoriasis. Psoriasis. Mark A. Bechtel, M.D. Director of Dermatology The Ohio State University College of Medicine
Psoriasis Mark A. Bechtel, M.D. Director of Dermatology The Ohio State University College of Medicine Psoriasis Psoriasis is a chronic skin disorder resulting from a polygenic predisposition combined with
More informationCardiovascular diseases. pathology
Cardiovascular diseases pathology Atherosclerosis Vascular diseases A disease that results in arterial wall thickens as a result of build- up of fatty materials such cholesterol, resulting in acute and
More informationRegistered Charity No: 326679 Caring for those with a rare, complex and lifelong disease www.behcets.org.uk
Registered Charity No: 326679 Caring for those with a rare, complex and lifelong disease www.behcets.org.uk Behçet s Disease and the Kidneys How are the kidneys affected by Behçet s disease? Kidney disease
More informationLYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis
LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the
More informationRheumatoid Arthritis
Rheumatoid Arthritis While rheumatoid arthritis (RA) has long been feared as one of the most disabling types of arthritis, the outlook has dramatically improved for many newly diagnosed patients. Certainly
More informationInfl ectra for rheumatoid arthritis
Infl ectra for rheumatoid arthritis Some important information to get you started with your treatment This booklet is intended only for use by patients who have been prescribed Inflectra. Introduction
More informationRheumatoid Arthritis. Outline. Treatment Goal 4/10/2013. Clinical evaluation New treatment options Future research Discussion
Rheumatoid Arthritis Robert L. Talbert, Pharm.D., FCCP, BCPS University of Texas at Austin College of Pharmacy University of Texas Health Science Center at San Antonio Outline Clinical evaluation New treatment
More informationPATTERNS OF ARTHRITIS: LAB AND OTHER TESTING
PATTERNS OF ARTHRITIS: LAB AND OTHER TESTING Paul B. Halverson MD Objectives Present several patterns of arthritis Where lab and imaging fit into various patient presentations Benefits and pitfalls related
More informationDisclosures. Consultant and Speaker for Biogen Idec, TEVA Neuroscience, EMD Serrono, Mallinckrodt, Novartis, Genzyme, Accorda Therapeutics
Mitzi Joi Williams, MD Neurologist MS Center of Atlanta, Atlanta, GA Disclosures Consultant and Speaker for Biogen Idec, TEVA Neuroscience, EMD Serrono, Mallinckrodt, Novartis, Genzyme, Accorda Therapeutics
More informationDiagnostics: Page 2 of 5
Proteinuria Proteinuria is a condition in which there are increased amounts of protein in the urine. There are a number of different diseases which can result in proteinuria. In the early stages of the
More informationGateway Health SM Non-Formulary Prior Authorization Criteria Intravenous Immune Globulin (IVIG)
Gateway Health SM Non-Formulary Prior Authorization Criteria Intravenous Immune Globulin (IVIG) Coverage is provided in the following situations: PARP Approved 6/2015 Coverage is provided for Primary Immunodeficiency
More informationchronic leukemia lymphoma myeloma differentiated 14 September 1999 Pre- Transformed Ig Surface Surface Secreted Myeloma Major malignant counterpart
Disease Usual phenotype acute leukemia precursor chronic leukemia lymphoma myeloma differentiated Pre- B-cell B-cell Transformed B-cell Plasma cell Ig Surface Surface Secreted Major malignant counterpart
More informationDisability Evaluation Under Social Security
Disability Evaluation Under Social Security *14.09 Inflammatory arthritis. As described in 14.00D6. With: A. Persistent inflammation or persistent deformity of: 1. One or more major peripheral weight-bearing
More informationRheumatoid arthritis
Rheumatoid arthritis Rheumatoid arthritis Chronic multisystem disease Unknown cause Characteristic feature persistent inflammation of synovia in symmetric peripheral joints Synovial inflammation cartilage
More informationINITIATING ORAL AUBAGIO (teriflunomide) THERAPY
FOR YOUR PATIENTS WITH RELAPSING FORMS OF MS INITIATING ORAL AUBAGIO (teriflunomide) THERAPY WARNING: HEPATOTOXICITY AND RISK OF TERATOGENICITY Severe liver injury including fatal liver failure has been
More informationSF-DCT INFORMATION FOR MIXED CONNECTIVE TISSUE DISEASE (MCTD) CLAIMS OPTION 1. (MCTD claims are not eligible for Disease Option 2)
SF-DCT INFORMATION FOR MIXED CONNECTIVE TISSUE DISEASE (MCTD) CLAIMS OPTION 1 (MCTD claims are not eligible for Disease Option 2) 1 Mixed Connective Tissue Disease (MCTD) Mixed Connective Tissue Disease
More informationIn non-hodgkin s lymphoma, MabThera is used to treat two types of the disease, both of which affect B-lymphocytes:
EMA/614203/2010 EMEA/H/C/000165 EPAR summary for the public rituximab This is a summary of the European public assessment report (EPAR) for. It explains how the Committee for Medicinal Products for Human
More informationDifferential Diagnosis
Differential Diagnosis Limited Scleroderma and Scleroderma-Like Disorders Morphea, or localized Scleroderma, usually begins between the ages of 20 to 50 years as patches of yellowish or ivory-colored rigid,
More informationInterpretation of Laboratory Values
Interpretation of Laboratory Values Konrad J. Dias PT, DPT, CCS Overview Electrolyte imbalances Renal Function Tests Complete Blood Count Coagulation Profile Fluid imbalance Sodium Electrolyte Imbalances
More informationArthritis in Children: Juvenile Rheumatoid Arthritis By Kerry V. Cooke
Reading Comprehension Read the following essay on juvenile rheumatoid arthritis. Then use the information in the text to answer the questions that follow. Arthritis in Children: Juvenile Rheumatoid Arthritis
More informationProf. of Tropical Medicine Faculty of Medicine Alexandria University
prof. Dr. Ali El-Kady (MD) Prof. of Tropical Medicine Faculty of Medicine Alexandria University DRUGS THAT MAY CAUSE LIVER DYSFUNCTION DAMAGE The liver is the principal organ that is capable of converting
More informationThe Most Common Autoimmune Disease: Rheumatoid Arthritis. Bonita S. Libman, M.D.
The Most Common Autoimmune Disease: Rheumatoid Arthritis Bonita S. Libman, M.D. Disclosures Two googled comics The Normal Immune System Network of cells and proteins that work together Goal: protect against
More informationPATIENT HEALTH QUESTIONNAIRE Radiation Oncology (Patient Label)
REVIEWED DATE / INITIALS SAFETY: Are you at risk for falls? Do you have a Pacemaker? Females; Is there a possibility you may be pregnant? ALLERGIES: Do you have any allergies to medications? If, please
More informationImmune-Mediated Low Platelet or Thrombocyte Count
rally is Customer Name, Street Address, City, State, Zip code Phone number, Alt. phone number, Fax number, e-mail address, web site Immune-Mediated Low Platelet or Thrombocyte Count (Thrombocytopenia)
More informationStructure of the presentation
Overlap syndromes Structure of the presentation Definition of overlap syndromes Concept of diseases with overlapping features Short description of diseases overlapping with myositis Specific overlap syndromes
More informationCervical lymphadenopathy
Cervical lymphadenopathy Introduction There are various classifications of lymphadenopathy, but a simple and clinically useful system is to classify lymphadenopathy as "generalized" if lymph nodes are
More informationRheumatoid Arthritis Information
Rheumatoid Arthritis Information Definition Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs. Alternative
More informationInformation on Rheumatoid Arthritis
Information on Rheumatoid Arthritis Table of Contents About Rheumatoid Arthritis 1 Definition 1 Signs and symptoms 1 Causes 1 Risk factors 1 Test and diagnosis 2 Treatment options 2 Lifestyle 3 References
More informationEVIDENCE BASED TREATMENT OF CROHN S DISEASE. Dr E Ndabaneze
EVIDENCE BASED TREATMENT OF CROHN S DISEASE Dr E Ndabaneze PLAN 1. Case presentation 2. Topic on Evidence based Treatment of Crohn s disease - Introduction pathology aetiology - Treatment - concept of
More informationThe Anorexic Cat For this reason, any cat that stops eating for any reason is considered an emergency situation.
The Anorexic Cat Introduction Any cat that stops eating (anorexic) or begins to eat much less than their normal amount should be seen by a veterinarian right away. The primary reason why a cat stops eating
More informationF r e q u e n t l y A s k e d Q u e s t i o n s
Myasthenia Gravis Q: What is myasthenia gravis (MG)? A: Myasthenia gravis (meye-uhss- THEEN-ee-uh GRAV uhss) (MG) is an autoimmune disease that weakens the muscles. The name comes from Greek and Latin
More informationDo I need a physician referral? Yes, we see patients on referral from a health care provider.
FAQS FOR OFFICE POLICIES How do I get an appointment? New appointments are made by physician referral only. Your referring health care provided will call for the appointment for you. What do I need to
More informationCommonly Asked Questions About Chronic Hepatitis C
Commonly Asked Questions About Chronic Hepatitis C From the American College of Gastroenterology 1. How common is the hepatitis C virus? The hepatitis C virus is the most common cause of chronic viral
More informationX-Plain Psoriasis Reference Summary
X-Plain Psoriasis Reference Summary Introduction Psoriasis is a long-lasting skin disease that causes the skin to become inflamed. Patches of thick, red skin are covered with silvery scales. It affects
More informationUnderstanding Rheumatoid Arthritis
Understanding Rheumatoid Arthritis Understanding Rheumatoid Arthritis What Is Rheumatoid Arthritis? 1,2 Rheumatoid arthritis (RA) is a chronic autoimmune disease. It causes joints to swell and can result
More informationTREATING AUTOIMMUNE DISEASES WITH HOMEOPATHY. Dr. Stephen A. Messer, MSEd, ND, DHANP Professor and Chair of Homeopathic Medicine
TREATING AUTOIMMUNE DISEASES WITH HOMEOPATHY Dr. Stephen A. Messer, MSEd, ND, DHANP Professor and Chair of Homeopathic Medicine AUTOIMMUNE DISEASES An autoimmune disorder occurs when the body s immune
More informationThymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available.
Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against
More informationBlood & Marrow Transplant Glossary. Pediatric Blood and Marrow Transplant Program Patient Guide
Blood & Marrow Transplant Glossary Pediatric Blood and Marrow Transplant Program Patient Guide Glossary Absolute Neutrophil Count (ANC) -- Also called "absolute granulocyte count" amount of white blood
More informationThyroid pathology in the Presence of antiviral treatment of chronic hepatitis C. Professor Nikitin Igor G Russian State Medical University MOSCOW
Thyroid pathology in the Presence of antiviral treatment of chronic hepatitis C Professor Nikitin Igor G Russian State Medical University MOSCOW The structure of the side effects associated with antiviral
More informationAutoimmune Diseases More common than you think Randall Stevens, MD
Autoimmune Diseases More common than you think Randall Stevens, MD picture placeholder Autoimmune Diseases More than 60 different disorders Autoimmune disorders (AID) diseases caused by the immune system
More informationDogs and cats with pancreatitis can have a wide variety of signs, which include, but are not limited to the following:
Pancreatitis is defined as inflammation of the pancreas and can be caused by a number of inciting factors. The pancreas is responsible for tasks such as glucose regulation and aids in the digestion of
More informationArthritis and Rheumatology Clinics of Kansas Patient Education. Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis
Arthritis and Rheumatology Clinics of Kansas Patient Education Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis Introduction: For as long as scientists have studied rheumatic disease,
More informationChildhood Cancer in the Primary Care Setting
Childhood Cancer in the Primary Care Setting Mohamed Radhi, M.D. Associate Professor, UMKC Pediatric Hematology/Oncology/BMT Children s Mercy Hospital I will discuss: Overview of childhood cancer Presentation
More informationZika Virus. Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases
Zika Virus Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases What is the incubation period for Zika virus infection? Unknown but likely to be several
More informationRheumatoid Arthritis. Nicole Klett,, M.D.
Rheumatoid Arthritis Nicole Klett,, M.D. Rheumatoid Arthritis Systemic Chronic Inflammatory Primarily targets the synovium of diarthrodial joints Etiology likely combination genetic and environmental Diarthrodial
More informationFor Your Information
For Your Information This publication contains information about medications used to treat the health condition discussed here. When this publication was printed, we included the most up-to-date (accurate)
More informationSummary of the risk management plan (RMP) for Accofil (filgrastim)
EMA/475472/2014 Summary of the risk management plan (RMP) for Accofil (filgrastim) This is a summary of the risk management plan (RMP) for Accofil, which details the measures to be taken in order to ensure
More informationNational MS Society Information Sourcebook www.nationalmssociety.org/sourcebook
National MS Society Information Sourcebook www.nationalmssociety.org/sourcebook Chemotherapy The literal meaning of the term chemotherapy is to treat with a chemical agent, but the term generally refers
More informationEye Manifestations of Lupus And Sjogren s Syndrome
Eye Manifestations of Lupus And Sjogren s Syndrome Based on a presentation by Dr. N. Kevin Wade at the BC Lupus Society Symposium held October 22, 2005. Background Dr. Wade completed his MD in 1998 at
More informationBiogen Idec Contacts: Media: Amy Brockelman (617) 914-6524 Investor: Eric Hoffman (617) 679-2812
NEWS RELEASE Media: Nikki Levy (650) 225-1729 Investor: Susan Morris (650) 225-6523 Biogen Idec Contacts: Media: Amy Brockelman (617) 914-6524 Investor: Eric Hoffman (617) 679-2812 GENENTECH AND BIOGEN
More informationEvaluation of a Child with Elevated Transaminases. Linda V. Muir, M.D. April 11, 2008 Northwest Pediatric Liver Disease Symposium
Evaluation of a Child with Elevated Transaminases Linda V. Muir, M.D. April 11, 2008 Northwest Pediatric Liver Disease Symposium Disclosures I do not have a financial interest, arrangement or affiliation
More informationSevere rheumatoid arthritis (a disease that causes inflammation of the joints),where MabThera is given intravenously together with methotrexate.
EMA/614203/2010 EMEA/H/C/000165 EPAR summary for the public rituximab This is a summary of the European public assessment report (EPAR) for. It explains how the Committee for Medicinal Products for Human
More informationINTRODUCTION Thrombophilia deep vein thrombosis DVT pulmonary embolism PE inherited thrombophilia
INTRODUCTION Thrombophilia (Hypercoagulability) is a condition in which a person forms blood clots more than normal. Blood clots may occur in the arms or legs (e.g., deep vein thrombosis DVT), the lungs
More informationWHAT IS SJÖGREN SYNDROME?
SjÖgren Syndrome WHAT IS SJÖGREN SYNDROME? Sjögren Syndrome (show-gren) is an autoimmune disease characterized by malfunction of the tear- and saliva-producing glands and the mucous-secreting glands of
More informationAmylase and Lipase Tests
Amylase and Lipase Tests Also known as: Amy Formal name: Amylase Related tests: Lipase The Test The blood amylase test is ordered, often along with a lipase test, to help diagnose and monitor acute or
More informationPreoperative Laboratory and Diagnostic Studies
Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no
More informationCanine Lymphoma Frequently Asked Questions by Pet Owners
Canine Lymphoma Frequently Asked Questions by Pet Owners What is lymphoma? The term lymphoma describes a diverse group of cancers in dogs that are derived from white blood cells called lymphocytes. Lymphocytes
More informationTHE ROLE OF RENAL BIOPSY IN GLOMERULAR DISEASES DIAGNOSTIC FRANCO FERRARIO FABIO PAGNI
THE ROLE OF RENAL BIOPSY IN GLOMERULAR DISEASES DIAGNOSTIC FRANCO FERRARIO FABIO PAGNI Nephropathology Center San Gerardo Hospital-Monza Milan-Bicocca University Italy Percutaneous Renal Biopsy has a fundamental
More informationSOUTH TAMPA MULTIPLE SCLEROSIS CENTER
SOUTH TAMPA MULTIPLE SCLEROSIS CENTER PATIENT/CARE GIVER QUESTIONNAIRE DEMOGRAPHIC INFORMATION Patient's Name: City: State: Zip Code: Phone: Marital Status: Spouse/Care Giver Name: Phone (H) (W) Occupation:
More informationUnderstanding How Existing and Emerging MS Therapies Work
Understanding How Existing and Emerging MS Therapies Work This is a promising and hopeful time in the field of multiple sclerosis (MS). Many new and different therapies are nearing the final stages of
More informationRHEUMATOID ARTHRITIS. Semmelweis University 3rd Department of Medicine. György Temesszentandrási MD
RHEUMATOID ARTHRITIS Semmelweis University 3rd Department of Medicine György Temesszentandrási MD Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease predominantly affecting diarthrodial
More informationMalignant Lymphomas and Plasma Cell Myeloma
Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations
More informationRheumatoid Arthritis:
Rheumatoid Arthritis Update 2014 Mark Hulsey, MD FACR Rheumatoid Arthritis Key Features Symptoms >6 weeks duration Often lasts the remainder of the patient s life Inflammatory synovitis Palpable synovial
More informationDRUGS FOR TREATING SYSTEMIC LUPUS ERYTHEMATOSUS: GLOBAL MARKETS
DRUGS FOR TREATING SYSTEMIC LUPUS ERYTHEMATOSUS: GLOBAL MARKETS PHM159A March 2014 Sanjukta Bhattacharyya Project Analyst ISBN: 1-56965-754-8 BCC Research 49 Walnut Park, Building 2 Wellesley, MA 02481
More informationMedical Surgical Nursing (Elsevier)
1 of 6 I. The Musculoskeletal System Medical Surgical Nursing (Elsevier) 1. Med/Surg: Musculoskeletal System: The Comprehensive Health History 2. Med/Surg: Musculoskeletal System: A Nursing Approach to
More informationTesting for RA. The Ideal Lab Test. William M. Wason, MD, PhD 9/24/2010. Confusion Abounds
Confusion Abounds Rheumatoid arthritis: ulnar deviation and muscle artrophy, hands Poor sensitivity and specificity Hepatitis C causes lots of false + tests Changing technology in how tests are done Historic
More informationREGISTRATION FORM PATIENT NAME: ADDRESS (STREET, CITY, STATE, ZIP): HOME PHONE: WORK PHONE: CELL PHONE: DATE OF BIRTH: / / AGE: SEX:
REGISTRATION FORM PATIENT NAME: ADDRESS (STREET, CITY, STATE, ZIP): HOME PHONE: WORK PHONE: CELL PHONE: E-MAIL ADDRESS: OCCUPATION: DATE OF BIRTH: / / AGE: SEX: SOCIAL SECURITY NUMBER: MARITAL STATUS:
More informationLEMTRADA REMS Education Program for Prescribers
For Prescribers LEMTRADA REMS Education Program for Prescribers This education program includes information about: The LEMTRADA REMS Program requirements Serious risks of autoimmune conditions, infusion
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure
More informationPediatric Oncology for Otolaryngologists
Pediatric Oncology for Otolaryngologists Frederick S. Huang, M.D. Division of Hematology/Oncology Department of Pediatrics The University of Texas Medical Branch Grand Rounds Presentation to Department
More informationEmory Eye Center New Patient Questionnaire
Patient Name: Date: Current Address: Current Phone: Date of Birth: Primary Care Physician: Referring Physician: (First & Last Name) (First & Last Name) Pharmacy Name: Phone #: ( ) Please answer all questions
More informationRheumatoid arthritis (RA) is a systemic inflammatory disorder which has pleuroparenchymal
Introduction: Rheumatoid arthritis (RA) is a systemic inflammatory disorder which has pleuroparenchymal involvement with varied manifestations which includes organizing pneumonia, interstitial fibrosis,
More informationInfluenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus:
Respiratory Disorders Bio 375 Pathophysiology General Manifestations of Respiratory Disease Sneezing is a reflex response to irritation in the upper respiratory tract and is associated with inflammation
More informationRheumatoid Arthritis: Key Features
Rheumatoid Arthritis: Key Features Symptoms >6 weeks duration Often lasts the remainder of the patient s life Inflammatory synovitis Palpable synovial swelling Morning stiffness >1 hour, fatigue Symmetrical
More information