Develop an understanding of the mechanisms resulting in autoimmunity, including the role of abnormal immune regulation and the importance of immune complexes as mediators of tissue injury. Understand the general classification of immunodeficiency disorders. Familiarize yourself with the pathogenesis of transplant rejection, particularly the rejection of renal allografts. Gain a general appreciation of the morphological characteristics of immune disorders. The multisystemic autoimmune diseases are related, but distinctive clinical entities characterized by B cell hyperactivity, formation of antinuclear antibodies, predisposing genetic factors, increased frequency in women of child bearing age, overlap syndromes, and tissue injury mediated by immune mechanisms, especially immune complexes.
Antinuclear antibodies are useful tests to screen for multisystemic autoimmune diseases.
SLE is a prototype multisystemic autoimmune disease in which tissue injury is often caused by immune complex deposits. The fundamental abnormality in SLE is disturbed regulation of B cell activity, but the pathogenetic mechanisms responsible for this problem are unknown. The overall frequency of SLE is estimated to be about 1 case per 2000 population. There is no definite racial or ethnic predilection. However, some patients with SLE will not fulfill these requirements the first time they are seen by a physician.