Essentials of Human Diseases
and Conditions
4th edition
Margaret Schell Frazier
Jeanette Wist Drzymkowski
Chapter 3
Immunologic Diseases and
Conditions
Learning Objectives
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Name the functional components of the
immune system.
Characterize the three major functions of the
immune system.
List examples of inappropriate responses of
the immune system.
Explain the difference between natural and
artificial immunity.
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Learning Objectives (cont’d.)
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Trace the formation of T cells and B cells from
stem cells.
Explain how T cells and B cells specifically
protect the body against disease.
List the five immunoglobulins and explain
complement fixation.
Explain the ways that HIV is transmitted.
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Learning Objectives (cont’d.)
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List the guidelines for universal precautions
and infection control.
Describe the primary absent or inadequate
response of the immune system in the
following diseases:
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Common variable immunodeficiency
Selective immunoglobulin A deficiency
Severe combined immunodeficiency disease
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Learning Objectives (cont’d.)
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Explain the destructive mechanisms in
autoimmune diseases.
Describe the symptoms and signs of
pernicious anemia. Name the primary
treatment.
Describe the systemic features of SLE. Recall
the diagnostic criteria.
Detail the pathology of rheumatoid arthritis.
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Learning Objectives (cont’d.)
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Specify the primary objectives of the
treatment for RA.
Compare the pathology of multiple sclerosis
to that of myasthenia gravis.
List the distinguishing diagnostic features of
ankylosing spondylitis.
Describe the pathology of vasculitis in
general terms.
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Chapter 3
Lesson 3.1
Orderly Function of the Immune System
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Functional components of the immune
system:
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lymphoid tissue
• Primary – thymus, bone marrow
• secondary – tonsils, adenoids, spleen, Peyer patches,
appendix
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

lymphocytes
antibodies
macrophages
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Orderly Function of the Immune System
(cont’d.)
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Major functions of the immune system:
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Protect the body against foreign organisms
Maintain homeostasis by eliminating damaged
cells (phagocytosis)
Battles infection
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Orderly Function of the Immune System
(cont’d.)

Inappropriate responses of the immune
system:
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Hyperactive (allergic) – excessive response
Immunodeficient (e.g., AIDS) – inadequate
response
Autoimmune (e.g., SLE) – misdirected response
Transplant rejection – attack to beneficial foreign
tissues
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Acquired Immunity
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Orderly Function of the Immune System
(cont’d.)
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Cellular elements of natural immunity:
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Natural killer cells (NK)
Polymorphonuclear neutrophils (PMN)
Macrophages
Cellular elements of acquired immunity:
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T lymphocyte cells
B lymphocyte cells
Phagocytes
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T cell and
B cell
Formation
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Orderly Function of the Immune System
(cont’d.)
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T lymphocyte cells include:
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Cytotoxic T cells: destroy virus-infected cells,
tumor cells, or allograft cells
Helper T cells: stimulate B cells and activate
cytotoxic T cells
Suppressor T cells: moderate the immune
response by inhibiting B and T cells
Memory T cells: are reactivated only by
re-exposure to previous antigen
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Orderly Function of the Immune System
(cont’d.)
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B lymphocyte cells include:
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Memory B cells: reactivated only by re-exposure
to previous antigen
Plasma cells: secrete antibodies that attach to
antigens
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Orderly Function of the Immune System
(cont’d.)
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Immunoglobulins
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IgG (75–85%)
IgA (5–15%)
IgM (5–10%)
IgD (0.2%)
IgE (0.5%)
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Orderly Function of the Immune System
(cont’d.)
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Complement fixation.
Activation of normally inactive proteins found
in plasma or body fluids. Pathogens are
destroyed by lysis of the cell membrane or by
phagocytosis.
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Immunodeficiency Diseases

Increased susceptibility to bacterial infections
resulting from a B cell deficiency.
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Increased susceptibility to viral, fungal, and
protozoan infections, usually from T cell
deficiency.
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Immunodeficiency Diseases (cont’d.)

Acquired Immunodeficiency Syndrome
(AIDS)

Caused by human immunodeficiency virus (HIV)
 Diagnosed by presence of HIV antibodies in the
blood (common test: ELISA; confirmation: Western
blot)
 HIV attacks helper T lymphocytes
 Reduces cell-mediated immunity
 Attacks nervous system directly
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Immunodeficiency Diseases (cont’d.)
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HIV transmission is through direct contact with blood
or semen of infected person
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sexual contact
blood transfusions and other blood products
contaminated shared needles (IV drug use, etc.)
accidental needle sticks
to fetus via placenta or during birth process from infected
mother
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Immunodeficiency Diseases (cont’d.)
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AIDS treatment
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Highly active antiviral therapy (HART)
Many drug combinations can be used
Drug toxicity and side effects exist
Prophylactic antibiotics
Currently no cure
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Immunodeficiency Diseases (cont’d.)
Universal Precautions
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Thorough and frequent hand washing.
Personal protective equipment worn as required by specific task (e.g.
gloves, gown, goggles, mask).
Proper disposal of all sharps in designated biohazard containers.
No needle recap prior to disposal.
Caution in handling of laboratory specimens.
Proper containment and disinfection of blood and body fluid spills.
Use clean mouthpieces and resuscitation bags.
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Immunodeficiency Diseases (cont’d.)
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Common Variable Immunodeficiency
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Selective Immunoglobulin A Deficiency
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
acquired B cell deficiency
inadequate production of IgA
Severe Combined Immunodeficiency

ineffective development and function of both T
cells and B cells
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Chapter 3
Lesson 3.2
Autoimmune Diseases
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Lymphocytes and antibodies are sensitized to
develop against the body’s own organs or
tissues.

May be triggered by disease, injury, metabolic
changes, or mutation in immunologically
competent cells.

May be caused by certain drugs or
chemicals, trauma, or viral infection.
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Autoimmune Diseases (cont’d.)
Pernicious anemia
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Impaired absorption of B12 and B12 deficiency
due to decreased gastric production of
hydrochloric acid and shortage of intrinsic
factor.
Treatment consists of monthly intramuscular
injections of vitamin B12 during the person’s
entire lifetime.
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Autoimmune Diseases (cont’d.)
Pernicious Anemia
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Symptoms: weakness and tingling and
numbness in extremities, altered vision,
lightheadedness, tinnitus, palpitations, weight
loss, digestive disturbances, sore tongue.

Signs: decreased red blood cell, white blood
cell, and platelet counts; increased red blood
cell mean volume; decreased hemoglobin
levels; jaundice; optic nerve atrophy;
decreased amount of gastric acid.
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Autoimmune Diseases (cont’d.)
Connective Tissue Diseases
 Systemic lupus erythematosus
 Scleroderma
 Sjogren syndrome
 Rheumatoid arthritis
 Juvenile rheumatoid arthritis
 Ankylosing spondylitis
 Polymyositis
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Autoimmune Diseases (cont’d.)
Systemic Lupus Erythematosus (SLE)
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Inflammation of skin, joints, nervous system,
kidneys, lungs, and other organs.
Butterfly rash across face may be present.
Other rashes may appear on other exposed skin
areas.
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Autoimmune Diseases (cont’d.)
Systemic Lupus Erythematosus (SLE)
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Butterfly face rash
Alopecia
Photosensitivity
Raynaud’s phenomenon
Thrombocytopenia
Discoid skin lesion
Nasopharyngeal ulceration
Polyarthritis
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Pleuritis or pericarditis
Protein or casts in the
urine
Hemolytic anemia
False-positive serology
Abnormal blood
antibodies
LE cells (leukocytes)
present in lab testing
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Autoimmune Diseases (cont’d.)
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Rheumatoid arthritis (RA)
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Chronic, inflammation and edema of the synovial
membranes surrounding joints.
Destruction of cartilage and adjacent bone.
May produce weight loss, fever, and malaise.
Joint pain and stiffness, especially in morning.
Bilateral joint tenderness, edema, erythema, warmth.
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Autoimmune Diseases (cont’d.)
Rheumatoid arthritis treatment aimed at:
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Reducing inflammation and pain
Preserving joint function
Preventing joint deformities
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Autoimmune Diseases (cont’d.)
Ankylosing spondylitis
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Inflammation and ossification of the joints leading to
decreased range of motion and spinal bone fusion.
Sacroiliac spine area is usually affected first and
results in recurring low back pain and morning
stiffness.
History may include inflammatory bowel disease, heel
pain, and family incidence of arthritic conditions
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Autoimmune Diseases (cont’d.)
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Multiple sclerosis (MS)
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Inflammatory disease of the central nervous
system.
Demyelination of nerves occurs in the brain and
spinal cord.
Signs and symptoms are primarily neurologic and
related to areas of myelin destruction.
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Autoimmune Diseases (cont’d.)
Myasthenia gravis (MG)
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Chronic progressive neuromuscular disorder.
Autoantibodies produced to acetylcholine receptor
in muscle cells.
Ineffective nerve-muscle junction results in severe
weakness, difficulty talking and swallowing,
drooping eyelids and diplopia.
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Autoimmune Diseases (cont’d.)
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Vasculitis
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Inflammation in the walls of blood vessels that
may lead to necrosis, thrombus formation, and
local infarct
Can be classified as small vessel or systemic;
affecting medium and large arteries
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