Auto-Immune Diseases

Questions and Answers

What is a common treatment option for managing Raynaud's phenomenon in patients with systemic sclerosis?

Beta blockers

Anticoagulants

Calcium channel blockers (correct)

Antidepressants

Which of the following is NOT a characteristic symptom of CREST syndrome?

Sclerodactyly

Telangiectasia

Digital ulcers (correct)

Calcinosis cutis

What oral manifestation is associated with microstomia in patients with systemic sclerosis?

Improved oral hygiene

Decreased taste sensation

Salivary gland enlargement

Increased risk of periodontal disease (correct)

What is the prognosis for patients with Chronic Cutaneous Lupus Erythematosus (CCLE)?

Better prognosis, with the possibility of remission Signup and view all the answers

Which of the following complications is most commonly associated with systemic sclerosis?

Pulmonary complications Signup and view all the answers

What is a characteristic symptom of rheumatoid arthritis?

Joint swelling due to fibrous tissue erosion Signup and view all the answers

What is one of the primary goals of dental treatment for patients with microstomia?

Enhance oral hygiene practices Signup and view all the answers

In the context of Rheumatoid Arthritis, what role do activated CD4+ T helper cells play?

They release cytokines to activate other inflammatory cells Signup and view all the answers

Which laboratory findings are typically associated with rheumatoid arthritis?

Presence of anti-citrullinated protein antibodies (ACPA) Signup and view all the answers

Which statement accurately describes joint involvement in Rheumatoid Arthritis?

Swelling and stiffness are common, especially in smaller joints Signup and view all the answers

Which autoantibody is typically present in patients with CREST syndrome?

Anti-centromere antibodies Signup and view all the answers

What is a potential transformation of Chronic Cutaneous Lupus Erythematosus (CCLE)?

Transforming into systemic lupus erythematosus (SLE) Signup and view all the answers

What lifestyle modification is recommended for patients with Raynaud’s phenomenon?

Avoid cold exposure Signup and view all the answers

What is the primary purpose of TNF antagonists in treating rheumatoid arthritis?

To suppress the inflammatory response Signup and view all the answers

Which of the following conditions can result in lichenoid lesions relevant to differential diagnosis?

Lichen planus Signup and view all the answers

Which dental treatment approach is recommended for patients with rheumatoid arthritis?

Short appointments with supportive joint positioning Signup and view all the answers

What is sclerodactyly primarily characterized by?

Thickening and tightening of the skin on fingers Signup and view all the answers

What is a common characteristic of the joint symptoms in Rheumatoid Arthritis?

Substantial fatigue and weakness accompany joint aches Signup and view all the answers

How does Sclerodactyly present in patients?

Thickening and tightening of the skin on fingers Signup and view all the answers

What is a primary concern when treating patients on immunosuppressive therapy for rheumatoid arthritis?

Potential for joint infections Signup and view all the answers

What is a recommended approach for managing patients with severe Lupus Erythematosus?

Employ systemic immunosuppressive treatment Signup and view all the answers

Which disease is triggered by a group A beta-hemolytic streptococcal infection?

Acute rheumatic fever Signup and view all the answers

What is an expected oral manifestation of rheumatoid arthritis?

Xerostomia due to medication side effects Signup and view all the answers

Which of the following is commonly associated with Raynaud Phenomenon?

Vasospasm of small arteries Signup and view all the answers

Sclerodactyly primarily affects which of the following areas?

Hands and fingers Signup and view all the answers

Digital ulcers in scleroderma are most commonly a result of which mechanism?

Poor oxygenation and blood flow Signup and view all the answers

Oral manifestations such as lichenoid changes in lupus can be mistaken for which condition?

Lichen planus Signup and view all the answers

Which treatment option is commonly recommended for managing symptoms of scleroderma?

Vasodilators Signup and view all the answers

Which oral condition is often a complication of autoimmune diseases such as lupus?

Periodontal disease Signup and view all the answers

Which factor is NOT typically associated with the treatment of digital ulcers in scleroderma?

Aggressive chemotherapy Signup and view all the answers

What is a primary dermatological manifestation of systemic lupus erythematosus (SLE)?

Butterfly rash Signup and view all the answers

What is a primary characteristic of Sjögren Syndrome?

It involves the salivary and lacrimal glands. Signup and view all the answers

Which treatment is commonly used for IgG4-related disease?

Systemic steroids Signup and view all the answers

What is the main disease mechanism associated with Graves disease?

Autoantibodies targeting TSH receptors Signup and view all the answers

Which of the following is NOT a typical manifestation of Sjögren Syndrome?

Digital ulcers Signup and view all the answers

Which demographic is most commonly affected by IgG4-related disease?

Middle-aged to older males Signup and view all the answers

What is the role of plasma cells in IgG4-related disease?

They produce elevated serum IgG4. Signup and view all the answers

Which of the following symptoms is most likely to occur in patients with sclerodactyly?

Decreased blood flow to fingers Signup and view all the answers

Which of these conditions primarily results in hyperthyroidism due to autoantibodies?

Graves disease Signup and view all the answers

Study Notes

Lupus Erythematosus

Sun exposure should be avoided to manage symptoms.
Mild cases treated with NSAIDs, antimalarials, or topical steroids.
Severe cases require systemic immunosuppressive therapy.
Prognosis for Systemic Lupus Erythematosus (SLE) shows a 75% survival rate over 20 years.
Chronic Cutaneous Lupus Erythematosus (CCLE) has a better prognosis with possible remission but may evolve into SLE.

Differential Diagnosis for Lichenoid Lesions

Conditions include lichen planus, lichenoid drug eruptions, reactions to dental amalgam, chronic ulcerative stomatitis, lupus erythematosus, graft-versus-host disease, and lichenoid dysplasia.

Rheumatoid Arthritis

A chronic inflammatory autoimmune disorder affecting around 1% of the U.S. population primarily attacking joints.
Presented more frequently in females, with both genetic and environmental factors contributing to its onset.
Activated CD4+ T helper cells release cytokines leading to inflammation of joints, skin, heart, blood vessels, and lungs.

Symptoms of Rheumatoid Arthritis

Common symptoms include fatigue, weakness, joint and muscle aches.
Joint involvement tends to be symmetrical, particularly in the hands, feet, knees, and elbows.
Symptoms feature swelling and stiffness, including temporomandibular joint pain in 75% of cases.

Systemic Sclerosis

Treatment includes penicillamine and corticosteroids; calcium channel blockers for Raynaud's phenomenon.
Difficult oral hygiene due to microstomia.
Prognosis is poor due to high risk of pulmonary, renal, and cardiac complications.

CREST Syndrome

A mild variant of limited systemic sclerosis characterized by anti-centromere antibodies.
Manifestations include calcinosis cutis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia.

Additional Considerations for Rheumatoid Arthritis

Advanced stages may present with pannus formation eroding bone and cartilage, leading to fibrous or bony ankylosis.
Laboratory tests include Rheumatoid Factor (RhF) and anti-citrullinated protein antibodies (ACPA) alongside elevated ESR and C-reactive protein.
Treatment regimens often consist of immunosuppressants, NSAIDs, and corticosteroids.

Dental Management in Rheumatoid Arthritis

Dental treatment should prioritize short appointments and joint support due to limited dexterity.
Patients may experience TMJ pain, swelling, and stiffness.

Acute Rheumatic Fever

An acute multisystem immune-mediated disease often triggered by group A beta-hemolytic streptococcal infections.
Autoantibodies formed against streptococcal cell wall antigens may cross-react with host amino acids in heart and joint tissues.

Oral Manifestations of Lupus Erythematosus

Oral lesions can appear lichenoid or nonspecific; discoid lupus erythematosus often overlaps with skin signs.

Sjögren Syndrome

A chronic autoimmune disorder affecting salivary and lacrimal glands leading to dry mouth (xerostomia) and dry eyes (xerophthalmia).

A fibro-inflammatory disorder characterized by elevated serum IgG4 and associated lymphocytic infiltration and fibrosis.
Primarily affects middle-aged to older males with glands such as submandibular, lacrimal, and various organs being involved.
Treatment often includes systemic steroids.

Graves Disease

An autoimmune condition with autoantibodies targeting TSH receptors resulting in hyperthyroidism.
More prevalent in females, especially between the ages of 30-40.

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