The document discusses diseases of immunity, including hypersensitivity reactions and autoimmune diseases. It describes the innate and adaptive immune system, cells involved like T cells, B cells, cytokines, and histocompatibility molecules. Hypersensitivity reactions are classified and immediate (Type I) hypersensitivity is explained, where re-exposure to an antigen leads to rapid allergic reactions mediated by IgE and mast cells.
This is a powerpoint presentation on the Topic of Diseases of the immune system, part 1 - Chapter 6, based on Robbin's textbook of pathology. Prepared by Dr. Ashish Jawarkar, who is Assistant professor at Parul institute of medical sciences and research, Vadodara. Please subscribe to our youtube channel https://www.youtube.com/channel/UCwjkzK-YnJ-ra4HMOqq3Fkw . Our facebook page: facebook.com/pathologybasics. Instagram handle @pathologybasics
This is a presentation on the topic of Inflammation and repair, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
This is a powerpoint presentation on the Topic of Diseases of the immune system, part 1 - Chapter 6, based on Robbin's textbook of pathology. Prepared by Dr. Ashish Jawarkar, who is Assistant professor at Parul institute of medical sciences and research, Vadodara. Please subscribe to our youtube channel https://www.youtube.com/channel/UCwjkzK-YnJ-ra4HMOqq3Fkw . Our facebook page: facebook.com/pathologybasics. Instagram handle @pathologybasics
This is a presentation on the topic of Inflammation and repair, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
Apoptosis is a
-pathway of cell death that is
-induced by an internally regulated program
-in which cells destined to die activate intrinsic enzymes that --degrade the cells’ own nuclear DNA and also nuclear and cytoplasmic proteins
-With minimal host reaction.
As a periodontist, I have included the basics of immunity from the periodontist point of view that will help in understanding the immunological basis of periodontal disease...
Apoptosis is a
-pathway of cell death that is
-induced by an internally regulated program
-in which cells destined to die activate intrinsic enzymes that --degrade the cells’ own nuclear DNA and also nuclear and cytoplasmic proteins
-With minimal host reaction.
As a periodontist, I have included the basics of immunity from the periodontist point of view that will help in understanding the immunological basis of periodontal disease...
A brief covering basics of immunity understanding and also allowing students to understand with ease the concepts of innate immunity, adaptive immunity, Tcell, Bcell, MHC molecular genetics, and also cytokines and also its role in various disease.
The immune response is how our body recognizes and defends itself against pathogens like bacteria, viruses, and substances that appear foreign and harmful.
introduction of adaptive immunity. classification of adaptive immunity, factor affecting it and mechanism of adaptive immunity comparison between adaptive immunity and innate immunity. characteristic of adaptive immunity . cell mediated immune responses immunoglobulins
types of immunoglobulins. functions of immunoglobulins, hypersensitivity reactions
Evaluation and importance of innate & adaptive immunity Dr. ihsan edan ab...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
For More Medicine Free PPT - http://playnever.blogspot.com/
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Describes the basic properties and mechanisms of T cells and B cells in maintaining Immune Response against foreign antigens or infections and covers the UG and PG portion of immunology.
Immunity is the ability of the body to defend itself against disease-causing organisms.
The immune system refers to a collection of cells, chemicals and processes that function to protect the body from foreign antigens, such as microbes (organisms, such as bacteria, fungi, and parasites), viruses, cancer cells, and toxins.
The structural and chemical barriers which protect us from infection, the immune system can be classified into two “lines of defense”: innate immunity and adaptive immunity
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
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Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
Securing your Kubernetes cluster_ a step-by-step guide to success !KatiaHIMEUR1
Today, after several years of existence, an extremely active community and an ultra-dynamic ecosystem, Kubernetes has established itself as the de facto standard in container orchestration. Thanks to a wide range of managed services, it has never been so easy to set up a ready-to-use Kubernetes cluster.
However, this ease of use means that the subject of security in Kubernetes is often left for later, or even neglected. This exposes companies to significant risks.
In this talk, I'll show you step-by-step how to secure your Kubernetes cluster for greater peace of mind and reliability.
Generating a custom Ruby SDK for your web service or Rails API using Smithyg2nightmarescribd
Have you ever wanted a Ruby client API to communicate with your web service? Smithy is a protocol-agnostic language for defining services and SDKs. Smithy Ruby is an implementation of Smithy that generates a Ruby SDK using a Smithy model. In this talk, we will explore Smithy and Smithy Ruby to learn how to generate custom feature-rich SDKs that can communicate with any web service, such as a Rails JSON API.
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
The Art of the Pitch: WordPress Relationships and SalesLaura Byrne
Clients don’t know what they don’t know. What web solutions are right for them? How does WordPress come into the picture? How do you make sure you understand scope and timeline? What do you do if sometime changes?
All these questions and more will be explored as we talk about matching clients’ needs with what your agency offers without pulling teeth or pulling your hair out. Practical tips, and strategies for successful relationship building that leads to closing the deal.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
LF Energy Webinar: Electrical Grid Modelling and Simulation Through PowSyBl -...DanBrown980551
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Then welcome to this PowSyBl workshop, hosted by Rte, the French Transmission System Operator (TSO)!
During the webinar, you will discover the PowSyBl ecosystem as well as handle and study an electrical network through an interactive Python notebook.
PowSyBl is an open source project hosted by LF Energy, which offers a comprehensive set of features for electrical grid modelling and simulation. Among other advanced features, PowSyBl provides:
- A fully editable and extendable library for grid component modelling;
- Visualization tools to display your network;
- Grid simulation tools, such as power flows, security analyses (with or without remedial actions) and sensitivity analyses;
The framework is mostly written in Java, with a Python binding so that Python developers can access PowSyBl functionalities as well.
What you will learn during the webinar:
- For beginners: discover PowSyBl's functionalities through a quick general presentation and the notebook, without needing any expert coding skills;
- For advanced developers: master the skills to efficiently apply PowSyBl functionalities to your real-world scenarios.
DevOps and Testing slides at DASA ConnectKari Kakkonen
My and Rik Marselis slides at 30.5.2024 DASA Connect conference. We discuss about what is testing, then what is agile testing and finally what is Testing in DevOps. Finally we had lovely workshop with the participants trying to find out different ways to think about quality and testing in different parts of the DevOps infinity loop.
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
UiPath Test Automation using UiPath Test Suite series, part 4DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 4. In this session, we will cover Test Manager overview along with SAP heatmap.
The UiPath Test Manager overview with SAP heatmap webinar offers a concise yet comprehensive exploration of the role of a Test Manager within SAP environments, coupled with the utilization of heatmaps for effective testing strategies.
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What will you get from this session?
1. Insights into SAP testing best practices
2. Heatmap utilization for testing
3. Optimization of testing processes
4. Demo
Topics covered:
Execution from the test manager
Orchestrator execution result
Defect reporting
SAP heatmap example with demo
Speaker:
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
21. CELLS OF THE IMMUNE SYSTEM Present Ag to CD4 T cells Precursors to macrophage lineage; cytokine release Class II MHC expressing cells Horse-shoe shaped nucleus Found in LN, blood, lungs and other organs Antigen Presenting Cells Monocytes Phagocytose and kill bacteria Parasitic defense and allergic response ___ None Staining with eosin ___ Granulocyte; short lifespan; multilobed nucleus Bilobed nucleus; heavily granulated cytoplasm See below Phagocytic cells: PMN’s Eosinophils Macrophages Kill antibody-decorated cells and virus-infected or tumor cells (no MHC restriction) Fc receptors for antibody: CD16, CD56, CD57 Large granular lymphocytes Natural Cytolytic cells: NK cells FUNCTION MARKERS CHARACTERISTICS CELLS
22. CELLS OF THE IMMUNE SYSTEM Initiate inflammatory and acute phase response; have antibacterial, antiviral and anti-tumor activities Transport Ag to LN Efficient Ag presenters Produce cytokines Filter particles from blood Large, granular cells; Fc and C3 receptors __ __ __ __ __ Possible residence in tissue, spleen, LN, and other organs; activated by IFN- γ and TNF Presence in skin LN, tissues CNS and brain Presence in liver See below Antigen Presenting Cells Macrophages Langerhan’s cells Dendritic cells Microglial cells Kupffer cells B cells FUNCTION MARKERS CHARACTERISTICS CELLS
23. CELLS OF THE IMMUNE SYSTEM Produce IL-2, other cytokines; stimulate T-cell and B-cell growth; promote B-cell differentiation, antibody production Promotes initial defenses (local) DTH, T killer cells Promote later humoral responses CD2, CD3, T-cell receptor CD2, CD3, T-cell receptor, CD4 IL-2, IFN- γ , lympho-toxin production IL-4, IL-5, IL-6, IL-10 production Mature in Thymus; large nucleus, small cytoplasm Helper/DTH cells; Activation by APCs via Class II MHC antigen presentation TH 1 subtype TH 2 subtype Antigen-Responsive Cells T cells (all) CD4 T cells FUNCTION MARKERS CHARACTERISTICS CELLS
24. CELLS OF THE IMMUNE SYSTEM Release Histamine, provide allergic response, anti-parasitic Fc receptor for IgE Granulocytic Other cells Basophils/Mast cells Produce antibody and present antigen Terminally differentiated, antibody factories Surface antibody, Class II MHC antigens __ Mature in Peyer’s patches, BM, bursal equivalent; large nucleus, small cytoplasm; activation by Ag and T-cell factors Small nucleus, large cytoplasm Antibody-, Producing Cells B cells Plasma cells Kill viral, tumor, non-self cells; secrete TH 1 lymphokines Suppress T- cell and B-cell response CD2, CD3, T-cell receptor, CD8 CD2, CD3, T-cell receptor, CD8 Recognition of Ag presented by Class I MHC antigens Recognition of Ag presented by Class I MHC antigens Antigen-Responsive Cells CD8 T killer cells CD8 T cells (suppressor cells ) FUNCTION MARKERS CHARACTERISTICS CELLS
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32. SUBSETS OF T HELPER CELLS IN RESPONSE TO STIMULI (MAINLY CYTOKINES)
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37. HLA and Disease Association 15.0 BW47 21-Hydroxylase deficiency 5 6 20 DR3 DR4 DR3/DR4 Type I diabetes 9 DR3 Primary Sjogren syndrome 13 DR3 Chronic active hepatitis 4 DR4 Rheumatoid arthritis 14 B27 Acute anterior uveitis 14 B27 Post-gonococcal arthritis 90 B27 Ankylosing spondylitis Relative Risk HLA Allele Disease
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41. ۩ Results in tissue injury or other pathophysiological changes ۩ Occurs when an already sensitized individual is re- exposed to the same foreign substance ۩ May be immediate or delayed Hypersensitivity Reactions and Tissue Injury
42. Ensuing tissue injury may be caused by: ۩ Release of vasoactive substances ۩ Phagocytosis or lysis of cells ۩ Activation of inflammatory & cytolytic components of complement system ۩ Release of cytokines, proteolytic enzymes and other mediators of tissue injury or inflammation Hypersensitivity Reactions and Tissue Injury
138. Antibody- mediated damage to the blood vessel in a renal allograft. The blood vessel is markedly thickened and the lumen is obstructed by proliferating fibroblast and foamy macrophages.
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143. Acute cellular rejection of a renal allograft R – Intense mononuclear cell infiltrate between the glomerulus and the tubules L – Tubules undergoing destruction by invading lymphocytes
154. SOME TYPES OF TRANSPLANTS Graft contains pluripotential cells that repopulate host stem cells Host assumes donor ABO group Danger of graft-versus-host reaction and CMV infection Bone marrow Better survival with kidney from living donor than from cadaver Kidney Best allograft survival rate Danger of transmission of C-J disease Cornea COMMENTS TYPE OF TRANSPLANT
165. PERIPHERAL TOLERANCE Silence potentially autoreactive T and B cells in peripheral tissues Best defined for T cells Mechanisms: 1. Anergy 2. Suppression by regulatory T cells 3. Deletion by activation-induced cell death
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167. PERIPHERAL TOLERANCE Suppression by regulatory T cells Regulatory T cells plays a major role in preventing immune reactions against self-antigens CD4 T cells is the best defined regulatory T cells that expresses CD25, the alpha chain of the IL-2 receptor, and a transcription factor of the forkhead family (Foxp3) ***both are required for the development and maintenance of functional CD4+ regulatory T cells Mutations in Fox3p result in severe autoimmunity ***cause of autoimmune disease called IPEX (immune dysregulation, polyendocrinopathy, enteropathy, X-linked)
168. PERIPHERAL TOLERANCE Deletion by activation-induced cell death CD4+ T cells that recognize self-antigens may receive signals that promote their death by apoptosis two mechanisms 1. Expression of a pro-apoptotic member of the Bcl family (Bim), without anti-apoptotic members of the family, Bcl-2 and Bcl-x unopposed Bim triggers apoptosis by the mitochondrial pathway 2. Involves the Fas-Fas ligand system engagement of Fas by FasL induces apoptosis of activated T cells by the death receptor pathway
179. ORGAN-SPECIFIC AUTOIMMUNE DISEASES Intrinsic factor and parietal cells BM of kidney & lung Islet cell Adrenal cortex Sperm Desmoglein in tight junctions of skin Thyroglobulin Thyroid peroxidase Pernicious anemia Goodpasture’s synd. IDDM Addison’s disease Male infertility Pemphigus Hashimoto’s Primary myxedema Antibody to cell components other than receptors Acetylcholine receptor TSH receptor Myasthenia gravis Grave’s disease Antibody to receptors Target of Immune Response Autoimmune Disease Type of Immune Response
180. NON-ORGAN SPECIFIC AUTOIMMUNE DISEASES IgG in joints dsDNA, histones RNP antigens (SS-A/Ro and SS-B/La) Myelin protein Rheumatoid arthritis SLE Sjogren’s syndrome (Sicca syndrome) Guillain-Barre synd. Antibody to cell components other than receptors Target of Immune Response Autoimmune Disease Type of Immune Response
199. Libman-Sacks endocarditis of the mitral valve in lupus erythematosus. The vegetations attached to the margin of the thickened valve leaflet are indicated by arrows.
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202. Lupus nephritis, focal proliferative type. There are two focal necrotizing lesions in the glomerulus (arrows)
203. Lupus nephritis, diffuse proliferative type. There is marked increase in cellularity throughout the glomrulus
204. Immune complex deposition in SLE. IF micrograph of a glomrulus stained with anti-IgG from a patient with diffuse proliferative lupus nephritis.
205. Immune complex deposition in SLE. Electron micrograph of a renal glomerular capillary loop showing subendothelial dense deposits corresponding to “wire loops” seen by light microscopy. Deposits are also seen in the mesangium.
206. Lupus nephritis. A glomerulus with several “wire loop” lesions representing extensive subendothelial deposits of immune complexes.
213. Multisystem manifestations of Rheumatoid arthritis. Although the initial manifestation is usually arthritis, Rheumatoid disease is a systemic illness.
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216. Rheumatoid synovitis. The synovium is swollen and shows villous pattern. There is great increase in chronic inflammatory cells in the synovial stroma, often with exudate in the joint space and fibrin deposited on the synovial surface.
217. Articular cartilage destruction. Vascular granulation tissue grows across the surface of the carilage (pannus) from the edges of the joint, and the articular surface shows loss of cartilage beneath the extending pannus.
218. The inflammatory pannus causes FOCAL DESTRUCTION OF BONE. At the edges of the joint there is osteolytic destruction of bone. This phase is associated with joint deformity.
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220. The characteristic deformity and soft tissue swelling associated with long-standing rheumatoid disease of the hands.
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224. Rheumatoid nodule. At the elbow there is a large raised subcutaneous nodule. The nodule is composed of degenerate collagen (arrow) surrounded by a chronic reaction with macrophages and giant cells, and walled off by fibrosis.
243. Multisystem manifestations of Systemic Sclerosis. Systemic Sclerosis affects a wide range of tissues and organ systems, often as a result of vascular obliteration.
244. The fingers in some patients with Systemic Sclerosis are narrowed, with tight shiny skin. Subcutaneous calcification (calcinosis cutis) can also be seen as white spots on the edges of the fingers.
Inflammation of the airways not only causes symptoms associated with widespread but variable airflow obstruction, it also results in an increase in airway hyperresponsiveness to a variety of stimuli (triggers) Environmental and genetic influences in asthma (inducers) act mainly by provoking airway inflammation, rather than directly stimulating airway hyperresponsiveness Triggers of bronchoconstriction, which are factors that provoke contraction of the sensitised airway wall, include a wide range of stimuli, such as exercise, cold air and pollen Allergens can act as both inducers and triggers
Table-5: Revised Criteria for the Classification of Systemic Lupus Erythematosus Criterion: Definition: 1. Malar rash Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds 2. Discoid rash Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions 3.Photosensitivity Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation 4. Oral ulcers Oral or nasopharyngeal ulceration, usually painless, observed by a physician 5. Arthritis Nonerosive arthritis involving two or more peripheral joints, characterized by tenderness, swelling, or effusion 6. Serositis Pleuritis - convincing history or pleuritic pain or rub heard by a physician or evidence of pleural effusion, or Pericarditis - documented by ECG or rub or evidence of pericardial effusion 7. Renal disorder Persistent proteinuria greater than 0.5 grams per day or greater than 3+ if quantitation not performed, or Cellular casts - may be red cell, hemoglobin, granular, tubular, or mixed 8. Neurologic disorder Seizures - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance, or Psychosis - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance 9. Hematologic disorder Hemolytic anemia - with reticulocytosis, or Leukopenia - less than 4,000/mm^3 (4.0x10^9/L) on two or more occasions, or Lymphopenia - less than 1,500/mm^3 (1.5x10^9/L) on two or more occasions, or Thrombocytopenia - less than 100,000/mm^3 (100x10^9/L) in the absence of offending drugs 10. Immunologic disorder Positive LE cell preparation, or Anti-DNA: antibody to native DNA in abnormal titer, or Anti-Sm: presence of antibody to Sm nuclear antigen, or False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test 11. Antinuclear antibody An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with "drug-induced lupus" syndrome The proposed classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a person shall be said to have systemic lupus erythematosus if any 4 or more of the 11 criteria are present, serially or simultaneously, during any interval of observation. In 1997, anti-phospholipid antibody was added to the list of criteria for the classification of SLE (Hochberg, M.C., Arthritis Rheum 40: 1725, 1997). ( From: Tan, E.M., Cohen, A.S., Fries, J.F., et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum. 25: 1271-1277, 1982)
Table-5: Revised Criteria for the Classification of Systemic Lupus Erythematosus Criterion: Definition: 1. Malar rash Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds 2. Discoid rash Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions 3.Photosensitivity Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation 4. Oral ulcers Oral or nasopharyngeal ulceration, usually painless, observed by a physician 5. Arthritis Nonerosive arthritis involving two or more peripheral joints, characterized by tenderness, swelling, or effusion 6. Serositis Pleuritis - convincing history or pleuritic pain or rub heard by a physician or evidence of pleural effusion, or Pericarditis - documented by ECG or rub or evidence of pericardial effusion 7. Renal disorder Persistent proteinuria greater than 0.5 grams per day or greater than 3+ if quantitation not performed, or Cellular casts - may be red cell, hemoglobin, granular, tubular, or mixed 8. Neurologic disorder Seizures - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance, or Psychosis - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance 9. Hematologic disorder Hemolytic anemia - with reticulocytosis, or Leukopenia - less than 4,000/mm^3 (4.0x10^9/L) on two or more occasions, or Lymphopenia - less than 1,500/mm^3 (1.5x10^9/L) on two or more occasions, or Thrombocytopenia - less than 100,000/mm^3 (100x10^9/L) in the absence of offending drugs 10. Immunologic disorder Positive LE cell preparation, or Anti-DNA: antibody to native DNA in abnormal titer, or Anti-Sm: presence of antibody to Sm nuclear antigen, or False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test 11. Antinuclear antibody An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with "drug-induced lupus" syndrome The proposed classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a person shall be said to have systemic lupus erythematosus if any 4 or more of the 11 criteria are present, serially or simultaneously, during any interval of observation. In 1997, anti-phospholipid antibody was added to the list of criteria for the classification of SLE (Hochberg, M.C., Arthritis Rheum 40: 1725, 1997). ( From: Tan, E.M., Cohen, A.S., Fries, J.F., et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum. 25: 1271-1277, 1982)
Table-5: Revised Criteria for the Classification of Systemic Lupus Erythematosus Criterion: Definition: 1. Malar rash Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds 2. Discoid rash Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions 3.Photosensitivity Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation 4. Oral ulcers Oral or nasopharyngeal ulceration, usually painless, observed by a physician 5. Arthritis Nonerosive arthritis involving two or more peripheral joints, characterized by tenderness, swelling, or effusion 6. Serositis Pleuritis - convincing history or pleuritic pain or rub heard by a physician or evidence of pleural effusion, or Pericarditis - documented by ECG or rub or evidence of pericardial effusion 7. Renal disorder Persistent proteinuria greater than 0.5 grams per day or greater than 3+ if quantitation not performed, or Cellular casts - may be red cell, hemoglobin, granular, tubular, or mixed 8. Neurologic disorder Seizures - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance, or Psychosis - in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance 9. Hematologic disorder Hemolytic anemia - with reticulocytosis, or Leukopenia - less than 4,000/mm^3 (4.0x10^9/L) on two or more occasions, or Lymphopenia - less than 1,500/mm^3 (1.5x10^9/L) on two or more occasions, or Thrombocytopenia - less than 100,000/mm^3 (100x10^9/L) in the absence of offending drugs 10. Immunologic disorder Positive LE cell preparation, or Anti-DNA: antibody to native DNA in abnormal titer, or Anti-Sm: presence of antibody to Sm nuclear antigen, or False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test 11. Antinuclear antibody An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with "drug-induced lupus" syndrome The proposed classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a person shall be said to have systemic lupus erythematosus if any 4 or more of the 11 criteria are present, serially or simultaneously, during any interval of observation. In 1997, anti-phospholipid antibody was added to the list of criteria for the classification of SLE (Hochberg, M.C., Arthritis Rheum 40: 1725, 1997). ( From: Tan, E.M., Cohen, A.S., Fries, J.F., et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum. 25: 1271-1277, 1982)