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Chapter 11. Immune System

The immune system is designed to attack and destroy foreign antigens and should be able to differentiate self from nonself. Failure to differentiate self from nonself may lead to which of the following? Select all that apply.

a. Addison disease

b. Rheumatoid arthritis

c. Systemic lupus erythematosus

d. Multiple sclerosis

Overall answer: Failure to differentiate self from nonself may lead to an autoimmune disease. An autoimmune disease is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.

Answer a is correct. Addison disease is an autoimmune disease. Addison disease is a disorder that results when your body produces insufficient amount of certain hormones produced by your adrenal glands. The gradual destruction of the adrenal cortex, the outer layer of the adrenal glands, by the body's immune system causes up to 80% of Addison cases. In autoimmune disorders, the immune system makes antibodies that attack the body's own tissues or organs and slowly destroy them. Adrenal insufficiency occurs when at least 90% of the adrenal cortex has been destroyed. As a result, often both cortisol and aldosterone are lacking.

Answer b is correct. Rheumatoid arthritis (RA) is a chronic disease that leads to inflammation of the joints and surrounding tissues. Although the cause of RA is unknown, RA is considered to be an autoimmune disease. The disease usually begins gradually with fatigue, loss of appetite, morning stiffness, widespread muscle aches, and weakness. Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body and may affect the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, and neck. Additional symptoms include: anemia, eye burning, hand and feet deformities, limited range of motion, low-grade fever, lung inflammation (pleurisy), nodules under the skin (sign of severe disease), numbness/tingling, and paleness. Joint destruction may occur within 1 to 2 years after the appearance of the disease.

Answer c is correct. Systemic lupus erythematosus (SLE) is a chronic, inflammatory autoimmune disorder. SLE may affect the skin, joints, kidneys, and other organs. Symptoms vary from person to person, and may come and go. The condition may affect one organ or body system at first. Others may become involved later. Almost all people with SLE have joint pain and most develop arthritis. Frequently affected joints are the fingers, hands, wrists, and knees. Inflammation of various parts of the heart may occur as pericarditis, endocarditis, or myocarditis. Chest pain and arrhythmias may result from these conditions. ...

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