APII223881223 - CME/CMLE - Rheumatic Diseases Associated with Anti-Jo-1 and SCL-70-APII223881223

APII223881223 - Educational Activity
Pdf Summary
The document, provided by Tammy Carter, PhD, serves as an educational commentary on rheumatic diseases with a focus on scleroderma and polymyositis/dermatomyositis. It is intended to help individuals earn CME/CMLE credits through the American Society for Clinical Pathology (ASCP).<br /><br />**Learning Objectives:**<br />Participants should be able to:<br />- Define rheumatic disease and associated conditions<br />- Discuss the etiological hypotheses for inflammatory diseases<br />- Describe diagnostic laboratory tests for inflammation and systemic autoimmune diseases<br />- Identify autoantibodies and target antigens associated with scleroderma and polymyositis/dermatomyositis.<br /><br />**Overview of Rheumatic Diseases:**<br />Rheumatic diseases are autoimmune and inflammatory conditions affecting connective tissues, muscles, bones, and organs. They encompass over 100 disorders, including rheumatoid arthritis, lupus, and gout. Chronic inflammation in these diseases leads to progressive damage, potentially affecting vital organs. The conditions are often complex, with their etiology linked to genetic and environmental factors that trigger autoantibody production. Extravascular immune complex and T-cell mediated damage are two primary hypotheses for their pathogenesis.<br /><br />**Epidemiology:**<br />These diseases are globally prevalent and can affect individuals of any age, sex, or race, with females and older individuals being more susceptible. The incidence also varies among different ethnic groups, body weights, and activity levels, with genetic predispositions further influencing susceptibility.<br /><br />**Laboratory Testing:**<br />Diagnosing rheumatic diseases involves a combination of patient history, physical examination, and specific lab tests. Common tests include:<br />- ESR: Elevated in inflammatory conditions<br />- CRP: Elevated during inflammation<br />- RF: Found in a significant percentage of rheumatoid arthritis patients<br />- Anti-CCP: Highly specific for rheumatoid arthritis<br />- ANA: Screening test for systemic autoimmune disorders, identifying autoantibodies associated with various conditions.<br /><br />**Specific Diseases - Scleroderma/CREST and Polymyositis/Dermatomyositis:**<br />- **Scleroderma/CREST:** Characterized by systemic sclerosis, fibrosis, vascular abnormalities, and degenerative changes, detectable through positive ANA tests showing speckled, nucleolar, or centromere patterns. Treatment is symptom-based, focusing on inflammation reduction and organ protection.<br />- **Polymyositis/Dermatomyositis:** These diseases impact skeletal muscles and may involve other systems like lungs and joints. ANA testing shows a cytoplasmic pattern. Treatment usually includes corticosteroids, physical, and speech therapy for muscle strength and function improvement.<br /><br />**Summary:**<br />Early detection and tailored treatment are crucial in managing rheumatic diseases to improve patient outcomes and quality of life. Immunological tests such as ANA screening and subsequent panels play a pivotal role in diagnosis and management.
Keywords
rheumatic diseases
scleroderma
polymyositis
dermatomyositis
autoantibodies
CME/CMLE credits
ASCP
inflammation
autoimmune
diagnostic tests