ImmunopatholoImmunopatholo

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CPC case (No:5-1)

• A 48 year old woman had joint pain with morning stiffness in her hands and feet, often lasting 4-5 hours. On examination, her metacarpophalangeal and metatarsophalangeal joints were tender, slightly swollen and warm. There were also subcutaneous nodules on the extensor surfaces of both wrists and elbows. Laboratory investigations revealed an elevated erythrocyte sedimentation rate, elevated serum gamma-globulin, and positive rheumatoid factor.

Figure: An x-ray of the patient’s hand ( Left). Normal synovial membrane ( Center). The patient’s synovial membrane ( Right).

( upper). A subcutaneous nodule (Left ) Severe hand deformities (Right) Histolologic appearance of a granuloma

What are the key features in the history and photographs? What is your diagnosis? Why?

Major Objectives:

To understand

1. The main features of the major types of

immunopathologic reactions.

2. The pathological features of transplant rejection.

3. Concepts of pathogenesis and classification of

common auto-immune diseases.

4. Concepts of congenital and acquired

immunodeficiency diseases.