Comparison of Inflammatory Diseases
| Rheumatoid Arthritis | Systemic Lupus Erythematosus | Ulcerative Colitis | |
| Pathophysiology |
|
||
| Etiology |
|
||
| Clinical Manifestations |
|
||
| Common Laboratory Tests |
|
||
| Treatment
|
Here’s a comparison of Inflammatory Diseases focusing on Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE), and Ulcerative Colitis (UC):
Pathophysiology
- Rheumatoid Arthritis (RA):
- Description: RA is an autoimmune disease characterized by chronic inflammation of the synovial joints, leading to synovial hyperplasia, joint destruction, and systemic inflammation.
- Mechanism: The immune system mistakenly attacks the synovial lining of the joints, resulting in an inflammatory response. Cytokines, such as TNF-α, IL-1, and IL-6, play a key role in driving inflammation and joint damage.
- Systemic Lupus Erythematosus (SLE):
- Description: SLE is a systemic autoimmune disease that affects multiple organ systems, including the skin, joints, kidneys, and central nervous system.
- Mechanism: The immune system produces autoantibodies that target various cellular components, such as DNA and nuclear proteins, leading to widespread inflammation and tissue damage.
- Ulcerative Colitis (UC):
- Description: UC is a chronic inflammatory bowel disease (IBD) affecting the colon and rectum, characterized by continuous mucosal inflammation.
- Mechanism: The exact cause is unclear, but it involves an inappropriate immune response to intestinal flora, leading to chronic inflammation of the colonic mucosa.
Etiology
- Rheumatoid Arthritis (RA):
- Genetic Factors: HLA-DR4 and other genetic predispositions.
- Environmental Factors: Smoking, infections, and possibly hormonal factors.
- Systemic Lupus Erythematosus (SLE):
- Genetic Factors: HLA-DR2, HLA-DR3, and other genetic predispositions.
- Environmental Factors: Sunlight exposure, infections, certain medications, and hormonal factors.
- Ulcerative Colitis (UC):
- Genetic Factors: Family history and specific gene variants such as those in the HLA region.
- Environmental Factors: Diet, antibiotic use, and other environmental triggers.
Clinical Manifestations
- Rheumatoid Arthritis (RA):
- Symptoms: Symmetrical joint pain, swelling, stiffness (especially in the morning), and fatigue. Extra-articular manifestations may include rheumatoid nodules, lung involvement, and vasculitis.
- Systemic Lupus Erythematosus (SLE):
- Symptoms: Malar rash, photosensitivity, joint pain, fever, fatigue, renal involvement (lupus nephritis), and neurological symptoms.
- Ulcerative Colitis (UC):
- Symptoms: Diarrhea with blood and mucus, abdominal pain, urgency, and tenesmus. Systemic symptoms may include weight loss and fatigue.
Common Laboratory Tests
- Rheumatoid Arthritis (RA):
- Tests: Rheumatoid factor (RF), Anti-cyclic citrullinated peptide (anti-CCP) antibodies, Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).
- Systemic Lupus Erythematosus (SLE):
- Tests: Antinuclear antibody (ANA), Anti-double-stranded DNA (anti-dsDNA), Anti-Smith (anti-Sm) antibodies, ESR, CRP, and complement levels (C3, C4).
- Ulcerative Colitis (UC):
- Tests: Fecal calprotectin, CRP, ESR, and colonoscopy with biopsy. Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) may also be present.
Treatment
- Rheumatoid Arthritis (RA):
- Medications: Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, biologics (e.g., TNF inhibitors), NSAIDs, and corticosteroids.
- Other Treatments: Physical therapy and possibly surgery for joint repair or replacement.
- Systemic Lupus Erythematosus (SLE):
- Medications: Hydroxychloroquine, corticosteroids, immunosuppressants (e.g., azathioprine, mycophenolate mofetil), and biologics (e.g., belimumab).
- Other Treatments: Sun protection and management of specific organ involvement.
- Ulcerative Colitis (UC):
- Medications: Aminosalicylates (e.g., mesalamine), corticosteroids, immunosuppressants (e.g., azathioprine), and biologics (e.g., infliximab).
- Other Treatments: Surgery (e.g., colectomy) may be required in severe cases. Dietary modifications and probiotics are sometimes used adjunctively.
This comparison highlights the similarities and differences in pathophysiology, etiology, clinical manifestations, laboratory tests, and treatment approaches for these three inflammatory diseases.