Autoimmunity and GBS.pdf

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UNIT VII: Immunological

Disorders

d. Autoimmune Disorders

Tanzeel Ul Rahman Nursing Instructor

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Tanzeel Ul Rahman Nursing Instructor

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Autoimmune Diseases

Immune response that has been generated

against self-antigens /Auto-Antigens/.

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Autoimmune Diseases

 An autoimmune disorder is a condition that occurs

when the immune system mistakenly attacks and destroys its own healthy body tissue.

 Autoimmune disorders affect both male and

females of all ages and ethnic backgrounds.

 There are over 80 known autoimmune disorders.

 In the autoimmune patient, the immune system

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Treatment

 People with autoimmune disorders that affect

the bones, joints, or muscles may need help with movement or other functions.

 Medicines are often prescribed to control or

reduce the immune system's response. They

are often called immunosuppressive

medicines. Such medicines may include

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Guillain-Barre syndrome

 Is an uncommon disorder in which your

body's immune system attacks your

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Clinical Manifestations

 Guillain-Barre syndrome often begins with

weakness, tingling or loss of sensation

starting in your feet and legs and spreading to your upper body and arms. These symptoms may begin, often not causing much notice, in your fingers and toes. In some people, symptoms begin in the arms or even the face.

As the disorder progresses, muscle

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Signs and symptoms

 Prickling, "pins and needles" sensations in

fingers, toes or both

 Weakness or tingling sensations in legs that

spread to your upper body

 Unsteady walking or inability to walk

 Difficulty with eye movement, facial movement,

speaking, chewing or swallowing Severe pain in your lower back

 Difficulty with bladder control or intestinal

functions

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Phases of the Syndrome

Patients suffering from Guilain-Barre syndrome usually experience just one attack that generally lasts for a few weeks, after which the attack stops spontaneously. The rest of the time is spent recovering from the attack.

 Acute phase

 Plateau phase

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Acute Phase

 Characterized by severe and rapid weakness,

especially in the lower extremities

 Loss of muscle strength progressing to

quadriplegia and respiratory failure

 Decreasing deep tendon reflexes;  decreasing vital capacity

 Parasthesias; numbness;  Pain, especially nocturnal;

 Facial muscle involvement (inability to wrinkle

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Acute Phase

 Involvement of the autonomic nervous system

manifested by bradycardia, sweating,

fluctuating blood pressure, notably

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Stabilizing/Plateau Phase

 Occurs 2 to 3 weeks after initial onset,

characterized by a leveling off of symptoms

Generally, the autonomic functions

characterized by: Fluctuating blood pressure

Cardiac dysrythmias and tachycardia

Paralytic ileus and urinary retention

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Recovery Stage

 May take from several months to 2 years

Marked by improvement in symptoms

Generally, muscle strength and function

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Diagnostics

 Spinal tap (lumbar puncture) Will show

elevated protein levels without increase in other cells

 Nerve function tests Electromyography reads

electrical activity in your muscle to determine if your weakness is caused by muscle damage or nerve damage.

 Nerve conduction studies assess how your

nerves and muscles respond to small

electrical stimuli. Pulmonary Function Tests

(PFT’s) and ABG’s Performed when

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Nursing Interventions

 Care is directed toward the treatment of

symptoms

 Monitor respiratory status

 Provide respiratory treatment

 Prepare to initiate respiratory support, mechanical

ventilation

 Monitor cardiac status

 Assess for complications of immobility

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Medical Management

 Immunoglobulin's  Plasmapherises