An overview of the applied immunology in general medicine field. Copyright belonged to owner, for educational purposes only

1. Clinical Immunology
Fadel Muhammad Garishah, BSc
Department of General Medicine
Faculty of Medicine Diponegoro University

2. The Human Immune System

3. Immune Disorders
• Immune deficiency
• Hypersensitivity
• Autoimmunity
• Immune reconstitution inflammatory
syndrome (IRIS)
• Immunotherapeutics

4. Immune Deficiency
• Primary Immunodeficiency
• Acquired Immunodeficiency

5. Primary Immune Deficiency
• Innate Immune System
– Phagocytic cells
• Severe congenital neutropenia
• Asplenia
• Leukocyte adhesion deficiency
• Impaired killing (chronic granulomatous formation)
– Receptors and signaling
• TLR defects
• Mandelian susceptibility to Mycobcaterial
– Complement deficiency
• classical, alternative or mycobacterial pathways

6. • Adaptive Immune System
– T Cells
• Severe combined immunodeficiency
• Di George Syndrome
• Hyper IgE Syndrome
• Wiskott-Aldrich Syndrome
• Ataxia-Telanglectasia syndrome
– B-Cells
• X-Linked and Autosomal Recessive Agammaglobulinemia
• Hyper IgM Syndrome
• Common variable immunodeficiency
• IgA deficiency
• Others
– Autoinflammatory syndrome

7. Clinical Symptoms
• Frequent and recurrent pneumonia, bronchitis, sinus
infections, ear infections, meningitis or skin
infections
• Inflammation and infection of internal organs
• Blood disorders, such as low platelet counts or
anemia
• Digestive problems, such as cramping, loss of
appetite, nausea and diarrhea
• Delayed growth and development

8. Therapeutics
• Symptomatics
• Antimicrobials
• Immunotherapy: IVIG, IFN-Gamma, Growth
factors
• Stem cell transplantation

9. Acquired Immune Deficiencies
• Human immunodeficiency virus infection
• Involvement of bone marrow by cancers
(leukemias, metastases)
• Protein-calorie malnutrition
• Immunosupressed by therapeutics (long
corticosteroid use, other Imsps)
• Irradiation and chemotherapeutics

10. Mechanisms

11. Therapeutics
• Antiretroviral therapy
• Immunostimulant
• Nutrition therapy
• Vaccination
• IVIG
• Bone marrow transplant

12. Hypersensitivities

13. Autoimmunity

14. Mechanisms of Autoimmunity

15. Autoimmune Diseases

16. Systemic Lupus Erythematosus

17. Autoantibodies
• Antinuclear antibody: Anti dsDNA, Anti centromere
• Anti-mitochondrial antibody: Anti-Cardiolipin
• Anti-cytoplasm antibody: Anti-neutrophil cytoplasmic
(C-ANCA, P-ANCA), Anti-smooth muscle (Anti actin),
Anti-TPO/Antimicrosomal
• Cell membrane: Anti-ganglioside, anti-GBM, anti-
glutamate
• Extracellular: Antithrombin, Rheumatoid Antibodies
• Multiple: Anti-phospolipid, anti-apolipoprotein

18. Immune reconstitution inflammatory
syndrome

19. Immunotherapeutics
• Classic antihistamines
• Immunostimulants
• Immunosuppressants
• Monoclonal antibodies
• Immunotherapy