Auto-immune disease ( Arthritis, Diabetes)

1. Bishajit Debnath
Primeasia University
Banani, Dhaka, Bangladesh.
E. Mail- Bishajitdebnath@yahoo.com

2. Definition and Introduction
 Mistakes normal tissue for non-self and begins to attack the tissue in
an attempt the body to destroy it
 Autoimmune diseases arise from an abnormal( immunoresponse ) of
the body against substances and tissues normally present in the body
(autoimmunity ).
To keep the body healthy by destroying that which it perceives to be
non-self.
Autoimmune Disease
The role of the immune system

3. Classification
It is possible to classify autoimmune diseases by corresponding type of
hypersensitivity: type-I (i.e. urticaria induced by autologous serum), type II, type
III, or type IV.
Effects
 It has been estimated that autoimmune diseases are among the top ten leading
causes of death among women in all age groups up to 65 years.
 A substantial minority of the population suffers from these diseases, which are
often chronic, debilitating, and life-threatening.
 There are more than 80 illnesses caused by autoimmunity.

4. Risk factor for autoimmune disease
 Gender: Females are almost three times as likely as males to have an
autoimmune disease, with adolescent girls and young women being at
greatest risk. For some diseases, such as scleroderma and lupus (SLE),
more than 85 percent of patients are female.
 Age: Most autoimmune diseases affect younger and middle-aged people.
Some illnesses begin specifically in childhood (as their name suggests)-
juvenile idiopathic arthritis
 Genetics: A family history of autoimmune disease puts a child at higher
risk.
 Race: African-Americans, for instance, Caucasians to develop lupus
(SLE) and scleroderma, but the opposite is true for type 1 diabetes and
multiple sclerosis (MS).
 Other illnesses: For example, kids with type 1 diabetes appear to be
more susceptible to developing celiac disease or Addison’s disease.

5. Types of Autoimmune Disease:
With the ability to crop up in virtually any part of the body, autoimmune
disease comes in many varieties. It is likely fall into one of two basic
Categories :
Categorie-1
Organ-specific disease (also called localized) focus on one organ or a
specific type of tissue. Among those that can affect children are:
 Addison’s disease (adrenal glands)
 celiac disease (gastrointestinal tract)
 Crohn’s disease (gastrointestinal tract)
 multiple sclerosis (MS)(brain/spinal cord)
 type 1 diabetes (pancreas) [ Available in BD]
 ulcerative colitis (gastrointestinal tract) etc.

6. Categories –II
Non-organ-specific disorders (also called systemic) cause
problems more widely throughout the body. Among those that
can affect children are: ( Affecting multiple part of the body)
Example:
Rheumatoid arthritis (joints, less commonly lungs, skin, eyes)
 Dermatomyositis (skin, muscles)
 Primary Raynaud’s disease (blood vessels)
 Rheumatic fever
 Scleroderma (skin, intestine, less commonly lungs, kidneys)
 Sjögren’s syndrome (salivary glands, tear glands, joints)
Systemic Lupus Erythematosus (skin, joints, kidneys, other) etc.

7. The symptoms of autoimmune disease vary depending on the disease as
well as the person's immune system. Common symptoms include:
 Anxiety or depression
 Blood sugar changes
 Digestive or gastrointestinal problems
 Dizziness, Fatigue
 Elevated fever and high body temperature
 Extreme sensitivity to cold in the hands and feet
 Infertility
 Inflammation
 Irritability

8. Definition:
 Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by
inflammatory polyarthritis, which affects peripheral joints, especially the small
joints of the hands and feet.
 Chronic untreated inflammation may lead to joint erosions and joint destruction.
Cause of Rheumatoid Arthritis:
Largely unknown
Genetics+ environmental
Possible Triggers:
1. Infection
2. smoking
3. Obesity stress female hormone
.

9. Pathology:
Because Rheumatoid arthritis is an autoimmune disease the immune system, instead of protecting
the body, attack it specifically attacking the synovium. The synovium is a thin membrane that lines
joints and when attacked it can lead to inflammation, bone erosion, cartilage destruction, and
possibly eventually complete loss of joint integrity

10. The clinical onset – infiltration of the synovial
membrane with
Lymphocytes
Plasma cells
Dendritic cells
Macrophages.
CD4+ T lymphocytes, including Th1 cells and Th17 cells
play a central role by interacting with other cells in the
synovium.

11.  All of these conditions will improve as the inflammation is controlled.
 Unfortunately rheumatoid arthritis has no known cure there are only various
treatment methods to help lessen the severity of the disease. There are
various different medications available to treat RA. NSAIDs or
 Non-steroidal Anti-inflammatory Agents are a common drug used in RA
treatment. They reduce acute inflammation, which in turn relieves pain and
improves mobility

12. Is Type 1 Diabetes An Autoimmune Disease
Type 1 Diabetes:
Autoimmune reaction’s role in Type 1 Diabetes
 Autoimmune reaction plays a decisive role in development of Type 1
Diabetes (T1D).
 The erroneous response of our defense system is known as
autoimmune reaction; to fight self.
 Environmental triggers activate immune system such that it fails to
recognize insulin producing beta cells in the pancreas, as own.
 Consequently, the auto antibodies formed gradually destroy the
insulin producing beta cells as though they were some invaders.

13. Cause of type-1 Diabetes:
The exact cause of type 1 diabetes is unknown, but a family history of diabetes,
viruses that injure the pancreas, and autoimmune processes, in which the body's own
immune system destroys the beta cells, are all thought to play a role.
Sign and Symptom:
The affected person may be seriously ill, even comatose, with very high glucose
levels and high levels of ketones (ketoacidosis)
Complication:
Type 1 diabetics may have more severe medical complications sooner than other
diabetics. About 40% of those with type 1 diabetes will develop serious kidney
problems leading to kidney failure by the age of 50.

14.  In addition to diabetes tests used for screening, diagnosing and monitoring,
a few other tests may be used in the evaluation of type 1 diabetes: specially
( glucose)
 Diabetes auto antibodies– this test may help distinguish between type 1 and
type 2 diabetes if the diagnosis is unclear. The presence of one or more of
these antibodies indicates type 1 diabetes.
 Insulin , C-peptide – to monitor insulin production
 Urine and/or blood ketones tests may be ordered to monitor people who
present at the emergency room with symptoms suggesting acute
hyperglycemia and to monitor those who are being treated for ketoacidosis.

15. Treatment of diabetes type-I
 There is currently no cure for type 1 diabetes, although there has
been some limited success with islet beta) cell transplantations as a
way to potentially restore insulin production.
 Diabetic treatment at the time of diagnosis is somewhat different
than ongoing treatment.
 Type 1 diabetics are sometimes diagnosed when symptoms are acute
, with very high blood glucose levels, electrolytes out of balance, and
in a state of diabetic ketoacidosis with some degree of dehydration
affecting the function of the kidneys.

16. Common Diagnosis Used in Autoimmune Disease
The health care provider will do a physical exam. Signs depend on the
type of disease.
Tests that may be done to diagnose an autoimmune disorder may
include:
 Antinuclear antibody tests
 Autoantibody tests
 CBC
 C-reactive protein (CRP)
 Erythrocyte sedimentation rate (ESR)

17. Treatment by Medication and Drugs:
Anti-inflammatory drugs - to reduce inflammation and pain
Corticosteroids - to reduce inflammation. They are sometimes used to
treat an acute flare of symptoms
Pain-killing medication - such as paracetamol and codeine
Immunosuppressant drugs - to inhibit the activity of the immune system
Physical therapy - to encourage mobility
Treatment for the deficiency - for example, insulin injections in the case
of diabetes
Surgery - for example, to treat bowel blockage in the case of Crohn's
disease

18. Vaccines Safe for Children:

Due to reports on viruses being possible triggers, there has been
considerable apprehension about routine vaccinations given to
children.
 Results conclude that vaccinations included in the schedule do not
increase the risk of Type 1 Diabetes. Furthermore, the studies show that
adequate vaccination against mumps and whooping cough reduces
the chances of juvenile diabetes.

19. Summary
 An autoimmune disorder occurs when a person's immune system
mistakenly attacks their own body tissues. Different autoimmune
disorders include diabetes, Graves' disease, inflammatory bowel disease,
multiple sclerosis, psoriasis, rheumatoid arthritis, scleroderma and
systemic lupus erythematosus.
 The immune system is a collection of special cells and chemicals
that fight infection-causing agents such as bacteria and viruses. An
autoimmune disorder occurs when a person's immune system
mistakenly attacks their own body tissues. Autoimmune

20. THANK YOU