AUTOIMMUNE DISEASES

Dr. Ansar Uddin Ahmed

Asst. Prof and Head
Dept. of Periodontology and oral pathology
 Introduction

Autoimmune diseases result from immune

reactions against host antigens (‘self ’
antigens). They may be mediated by
antibodies (humoral response) or T cells
(cell-mediated) or both. In many cases the
exact mechanisms are unknown.
Autoimmune diseases occur in upto 3-5% of
the general population. They are common in
females. They are classified as
1. Organ-specific
2. Multisystem
 ORGAN-SPECIFIC AUTOIMMUNE
DISEASES
I. Hematological disorders
a. Autoimmune Hemolytic Anemia
b. Immune Thrombocytopenic Purpura
II. Gastrointestinal diseases
a. Pernicious anemia
III. Dermatologic diseases
a. Pemphigus Vulgaris
b. Mucous membrane pemphigoid (MMP)
d. Oral Lichen Planus (OLP)
d. Erythema Multiforme
 SYSTEMIC AUTOIMMUNE DISEASES

1. Systemic lupus erythematous

2. Rheumatoid Arthritis (RA)
3. Sjogren syndrome (SS)
4. Scleroderma.
6. Reiter’s Syndrome
7. Behcet’s disease
8. Recurrent aphthous stomatitis (RAS)
 Typical features of autoimmune
disease
 Significantly more common in women
 Onset often in middle age
 Levels of immunoglobulins usually raised
 Family history frequently positive
 Circulating autoantibodies frequently also
detectable in unaffected family members
 Multiple circulating autoantibodies to several
different and possibly unrelated antigens
 Often a higher risk of developing a second
autoimmune disease
 Immunosuppressive or anti-inflammatory
Autoimmune Hemolytic Anemia

Oral manifestations include –

deposition of blood pigment in the enamel and
dentin of the developing teeth, giving them a
green, brown or blue hue.
 Immune Thrombocytopenic Purpura (ITP)
Oral manifestations are-
1. Gingival bleeding
2. Petechiae more commonly on the palate
3. Mucocutaneous bleeding and haemorrhage into
tissues.
4. Oral surgical procedures mainly extractions are
contraindicated because of excessive bleeding and
should be carried out only after the deficiency is
compensated.
 Pernicious anemia

1. Glossitis is the most common oral manifestation of

pernicious anemia.
2. Tongue is smooth and beefy red because of
atrophic glossitis.
3. Taste sensation also may be diminished.
 Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an

Autoimmune disease caused by
autoantibodies against DNA and its
Associated Proteins. It is a disease of early
adulthood and middle age. SLE can affect
almost any body system. Females are eight
times more frequently affected than men.
Features of lupus erythematosus of
importance in dentistry
• Association with Sjögren’s syndrome
• Painful oral lichen-planus-like lesions
• Chronic anaemia and its sequelae
• Bleeding tendencies (antiplatelet antibodies or
anticoagulants)
• Cardiac disease and risk of endocarditis
• Lower lip vermillion border involvement is potentially
malignant
 Organs and tissues affected in
systemic lupus erythematosus

 Joints- Joint pains and arthritis

 Skin- Rashes, erythema nodosum
 Mouth- Stomatitis, Sjögren’s syndrome
 Serous membranes- Pleurisy, pericarditis
 Heart- Endocarditis, myocarditis, pericarditis
 Lungs- Pneumonitis
 Kidneys- Nephritic syndrome, kidney failure
 Central nervous system-
Neuroses, psychoses, strokes, cranial
nerve palsies
 Eyes- Conjunctivitis, retinal damage
 Gastrointestinal tract- Hepatomegaly,
pancreatitis
 Blood- Anaemia, purpura
Treatment-
1. Non-steroidal anti-inflammatory drugs
2. Corticosteroids
3. Antimalarials
4. Methotrexate