Digestive Involvement in Systemic Autoimmune Diseases (eBook)

Cover 1
Dedication 6
Foreword 8
List of Contributors 10
Contents 14
Part I: Introduction 16
Chapter 1. Digestive System and Autoimmunity 18
1. The digestive system and gut-associated immunity 18
2. Self-tolerance and autoimmunity 21
3. Tolerance mechanisms for autoreactive B cells in the bone marrow 21
4. Tolerance mechanisms for autoreactive T cells in the thymus 22
5. Clonal anergy and tuning 22
6. Extrinsic controls of self-reactive lymphocytes 23
7. Limitation of costimuli 23
8. Regulation of self-reactive lymphocytes in follicles 24
9. Tolerance at the effector phase 24
10. Conclusions 24
References 25
Chapter 2. Imaging Techniques in Digestive Diseases 30
1. Introduction 30
2. Imaging modalities 30
3. Future prospects 41
References 41
Part II: Systemic Autoimmune Diseases 44
Chapter 3. Systemic Lupus Erythematosus 46
1. Introduction 46
2. General symptoms 46
3. Oral cavity, oesophagus, and gastric abnormalities 46
4. Main gastrointestinal syndromes 47
5. Lupus-associated pancreatitis 52
References 52
Chapter 4. Antiphospholipid Syndrome 54
1. Introduction 54
2. Digestive involvement in APS 55
3. Gastrointestinal involvement 55
4. Hepatic involvement 57
5. Splenic involvement 60
6. Pancreatic involvement 61
References 61
Chapter 5. Gastrointestinal Involvement in Systemic Sclerosis 66
1. Pathogenesis of GIT dysmotility 66
2. Esophagus 67
3. Stomach 70
4. Small bowel 71
5. Colon and anorectal disorders 73
6. Patient-reported outcome measure 74
7. Conclusion 74
Acknowledgment 75
References 75
Chapter 6. Inflammatory Myopathies 78
1. Introduction 78
2. Oral cavity 79
3. Dysphagia 80
4. Bowel 81
5. Liver 81
6. Juvenile dermatomyositis 82
7. Summary 82
References 82
Chapter 7. Digestive Involvement in Primary Sjögren’s Syndrome 86
1. Esophageal involvement 87
2. Gastric involvement 87
3. Intestinal involvement 88
4. Pancreatic involvement 89
5. Liver involvement 90
References 93
Chapter 8. Gastrointestinal Involvement in Systemic Vasculitis 98
1. Introduction 98
2. Large-vessel vasculitis 99
3. Takayasu’s arteritis 99
4. Giant cell arteritis 100
5. Chronic periaortitis (Index case) 102
6. Medium-sized vessel vasculitis 104
7. Small-sized vessels vasculitis 105
8. Mixed cryoglobulinemia, HCV infection and gastrointestinal involvement 107
References 111
Chapter 9. Mixed Connective Tissue Disease 116
1. Are gastrointestinal features a common manifestation of mixed connective tissue disease? 116
2. Oral manifestations 117
3. Esophageal dysfunction 118
4. Bowel manifestations 119
5. Other conditions 119
6. Therapeutic considerations 120
7. Discussion 120
8. Summary 121
References 121
Chapter 10. Gastrointestinal Manifestations of Rheumatoid Arthritis 124
1. Manifestations directly due to rheumatoid arthritis 124
2. Gastrointestinal disease resulting from rheumatoid arthritis therapeutics 126
3. Mimics of gastrointestinal disease in rheumatoid arthritis 127
4. Summary and conclusions 129
References 129
Part III: Autoimmune Liver Diseases 134
Chapter 11. Immunopathogenesis of Autoimmune Liver Damage 136
1. Disturbances in antigen recognition 137
2. Deficiencies in regulatory networks 139
3. Genetic and gender predispositions 143
4. Summary 149
References 149
Chapter 12. Primary Biliary Cirrhosis 156
1. Introduction 156
2. Epidemiological highlights 156
3. Pathophysiological insights 157
4. Clinical presentations 160
5. Natural history and prognostic considerations 161
6. Treatment considerations 162
7. Conclusion 163
References 163
Chapter 13. Autoimmune Hepatitis 168
1. Definition 168
2. History and epidemiology 168
3. Clinical features 169
4. Diagnosis and laboratory findings 169
5. Pathophysiology 173
6. Management and prognosis 177
7. Recurrence of AIH after transplant 178
8. De novo AIH after transplant 178
9. Conclusion 179
References 179
Chapter 14. Primary Sclerosing Cholangitis 184
1. Aetiology 184
2. Diagnosis 190
3. Small duct PSC 190
4. Autoimmune pancreatitis (AIP) 190
5. Prognosis 190
6. Conclusion 199
References 199
Part IV: Autoimmunity and Viral Hepatitis 204
Chapter 15. Systemic and Autoimmune Manifestations of Hepatitis B Virus Infection 206
1. Introduction 206
2. Hepatitis B virus infection 207
3. Extra-hepatic manifestations of HBV infection 209
References 220
Chapter 16. Extrahepatic Manifestations in Patients with Chronic Hepatitis C Virus Infection 224
1. Introduction 224
2. Autoantibodies and HCV 224
3. Organ-specific autoimmune diseases and HCV 225
4. Systemic autoimmune diseases and HCV 226
5. Hematological diseases and HCV 233
6. Therapeutic management of extrahepatic features 235
References 237
Part V: Other Conditions 244
Chapter 17. Autoantibodies in Gastrointestinal Autoimmune Diseases 246
1. Antibodies in inflammatory bowel diseases 246
2. Antibodies in celiac disease 249
3. Antibodies in autoimmune liver diseases 251
References 255
Chapter 18. Gastrointestinal Complications of Anti-Rheumatic Drugs 258
1. Introduction 258
2. The clinical setting 258
3. Gastrointestinal reactions in autoimmune arthropathies 261
4. Coxibs versus non-selective NSAIDs 266
5. Potential for impact of arthritic disease 269
6. GI symptomatic adverse drug reactions 270
7. Enter the second-generation coxibs 270
8. Strategies to minimise or eliminate gastrointestinal complications 271
9. Discussion and conclusions 281
References 281
Subject Index 292
Colour Plate Section 312