Biology of Disease

(cid:55)(cid:94)(cid:100)(cid:97)(cid:100)(cid:92)(cid:110)(cid:21)(cid:100)(cid:91)(cid:21)(cid:21) (cid:57)(cid:94)(cid:104)(cid:90)(cid:86)(cid:104)(cid:90) (cid:55)(cid:94)(cid:100)(cid:97)(cid:100)(cid:92)(cid:110)(cid:21)(cid:100)(cid:91)(cid:21)(cid:21) (cid:57)(cid:94)(cid:104)(cid:90)(cid:86)(cid:104)(cid:90) (cid:67)(cid:90)(cid:104)(cid:104)(cid:86)(cid:103)(cid:21)(cid:54)(cid:93)(cid:98)(cid:90)(cid:89) (cid:66)(cid:86)(cid:99)(cid:88)(cid:93)(cid:90)(cid:104)(cid:105)(cid:90)(cid:103)(cid:21)(cid:66)(cid:90)(cid:105)(cid:103)(cid:100)(cid:101)(cid:100)(cid:97)(cid:94)(cid:105)(cid:86)(cid:99)(cid:21)(cid:74)(cid:99)(cid:94)(cid:107)(cid:90)(cid:103)(cid:104)(cid:94)(cid:105)(cid:110)(cid:33)(cid:21)(cid:74)(cid:64) (cid:66)(cid:86)(cid:106)(cid:103)(cid:90)(cid:90)(cid:99)(cid:21)(cid:57)(cid:86)(cid:108)(cid:104)(cid:100)(cid:99)(cid:21) (cid:66)(cid:86)(cid:99)(cid:88)(cid:93)(cid:90)(cid:104)(cid:105)(cid:90)(cid:103)(cid:21)(cid:66)(cid:90)(cid:105)(cid:103)(cid:100)(cid:101)(cid:100)(cid:97)(cid:94)(cid:105)(cid:86)(cid:99)(cid:21)(cid:74)(cid:99)(cid:94)(cid:107)(cid:90)(cid:103)(cid:104)(cid:94)(cid:105)(cid:110)(cid:33)(cid:21)(cid:74)(cid:64) (cid:56)(cid:93)(cid:103)(cid:94)(cid:104)(cid:21)(cid:72)(cid:98)(cid:94)(cid:105)(cid:93)(cid:21) (cid:66)(cid:86)(cid:99)(cid:88)(cid:93)(cid:90)(cid:104)(cid:105)(cid:90)(cid:103)(cid:21)(cid:66)(cid:90)(cid:105)(cid:103)(cid:100)(cid:101)(cid:100)(cid:97)(cid:94)(cid:105)(cid:86)(cid:99)(cid:21)(cid:74)(cid:99)(cid:94)(cid:107)(cid:90)(cid:103)(cid:104)(cid:94)(cid:105)(cid:110)(cid:33)(cid:21)(cid:74)(cid:64) (cid:58)(cid:89)(cid:21)(cid:76)(cid:100)(cid:100)(cid:89) (cid:74)(cid:99)(cid:94)(cid:107)(cid:90)(cid:103)(cid:104)(cid:94)(cid:105)(cid:110)(cid:21)(cid:100)(cid:91)(cid:21)(cid:65)(cid:90)(cid:90)(cid:89)(cid:104)(cid:33)(cid:21)(cid:74)(cid:64) Published by: Taylor & Francis Group In US: 270 Madison Avenue New York, NY 10016 In UK: 2 Park Square, Milton Park Abingdon, OX14 4RN This edition published in the Taylor & Francis e-Library, 2007. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” © 2007 by Taylor & Franics Group ISBN: 0-7487-7210-3 This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. All rights reserved. No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, micro?lming, and recording, or in any information storage or retrieval system, without written permission from the publishers. A catalog record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Biology of disease / Nessar Ahmed … [et al.]. p. ; cm. Includes bibliographical references and index. ISBN 0-7487-7210-3 (alk. paper) 1. Pathology--Textbooks. 2. Diseases--Textbooks. 3. Medical sciences--Textbooks. I. Ahmed, Nessar. [DNLM: 1. Pathology--methods. 2. Disease. QZ 4 B615 2007] RB111.B482 2007 616--dc22 2006026001 ISBN 0-203-50472-0 Master e-book ISBN Senior Publisher: Jackie Harbor Editor: Elizabeth Owen Editorial Assistant: Kirsty Lyons Production Editor: Karin Henderson Illustrated by: Mick Hoult Typeset by: Phoenix Photosetting, Chatham, Kent, UK Printed by: Cromwell Press, Trowbridge, Wilts, UK Printed on acid-free paper 10 9 8 7 6 5 4 3 2 1 Taylor & Francis Group, an informa business Visit our web site at http://www.garlandscience.com To our families CONTENTS Preface xvii Glossary xix Chapter 1: The Nature and Investigation of Diseases 1 1.1 Introduction 1 1.2 CharacteristicFeaturesofDiseases 2 Etiology 2 Pathogenesis 3 ManifestationsofDiseases 4 OutcomeofaDisease 5 1.3 Classi?cationofDiseases 6 1.4 EpidemiologyofDisease 7 1.5 InvestigatingDiseases 8 1.6 TypesofPathologyLaboratories 9 1.7 RoleofHospitalLaboratoryTests 10 1.8 HospitalLaboratoryTests 14 1.9 EvaluationofLaboratoryTests 16 1.10 ReferenceRanges 17 1.11 QualityofTestResultsandClinicalAuditing 18 1.12 Summary 21 FurtherReading 22 Chapter 2: Pathogens and Virulence 25 2.1 Introduction 25 2.2 TypesofPathogens 26 Prions 26 Viruses 27 Bacteria 30 Protozoa,FungiandHelminths 30 ArthropodsandVertebrates 31 2.3 VirulenceFactors 33 DefensiveVirulenceFactors 33 OffensiveVirulenceFactors 34 2.4 CourseofInfection 37 2.5 Summary 38 FurtherReading 39 (cid:107)(cid:94)(cid:94) (cid:67)(cid:90)(cid:104)(cid:104)(cid:86)(cid:103)(cid:21)(cid:54)(cid:93)(cid:98)(cid:90)(cid:89)(cid:33)(cid:21)(cid:66)(cid:86)(cid:106)(cid:103)(cid:90)(cid:90)(cid:99)(cid:21)(cid:57)(cid:86)(cid:108)(cid:104)(cid:100)(cid:99)(cid:33)(cid:21)(cid:56)(cid:93)(cid:103)(cid:94)(cid:104)(cid:21)(cid:72)(cid:98)(cid:94)(cid:105)(cid:93)(cid:21)(cid:27)(cid:21)(cid:58)(cid:89)(cid:21)(cid:76)(cid:100)(cid:100)(cid:89) CONTENTS Chapter 3: Infectious Diseases and Treatments 41 3.1 Introduction 41 3.2 InfectionsoftheSkin 42 3.3 InfectionsoftheEyes,EarsandCentralNervousSystem 42 3.4 InfectionsoftheRespiratorySystem 44 3.5 InfectionsoftheGastrointestinalTract 46 3.6 InfectionsoftheUrogenitalSystem 48 3.7 SepsisandSystemicInfections 53 3.8 InvestigatingInfectiousDiseases 54 Culture 54 SerologicalTests 55 BiochemicalandMolecularBiologicalTechniques 56 3.9 PreventingInfectiousDiseases 59 3.10 ControllingtheSpreadofPathogens 60 3.11 TreatmentofInfectiousDiseases 60 AntiviralDrugs 60 AntibacterialDrugs 61 Antifungal,AntiprotozoalandAntihelminthicDrugs 64 CombinationTherapy 66 Surgery 66 3.12 Summary 69 FurtherReading 70 Chapter 4: The Immune System 73 4.1 Introduction 73 4.2 TypesofImmuneDefense 74 4.3 Nonspeci?cDefenses 74 Interferons 74 Complement 75 Nonspeci?cCells 75 MononuclearLeukocytes 77 In?ammationandtheAcutePhaseResponse 77 4.4 Speci?cImmuneResponses 79 RolesofHumoralandCell-MediatedImmunity 80 HumoralImmunity 80 Cell-MediatedImmunity 85 4.5 SmallLymphocytes 86 4.6 ProductionofaSpeci?cImmuneResponse 87 HumoralImmunity 89 4.7 Summary 95 FurtherReading 97 Chapter 5: Disorders of the Immune System 99 5.1 Introduction 99 5.2 Immunode?ciencyDiseases 100 PrimaryImmunode?ciencyDisease 100 5.3 AutoimmuneDisorders 110 Classi?cationofAutoimmuneDisorders 110 AutoimmuneDisordersAffectingEndocrineGlands 111 AntiglomerularBasementMembraneDisease 113 MyastheniaGravis 114 RheumatoidArthritis 115 SystemicLupusErythematosus 116 5.4 ImmunologicalHypersensitivity 118 TypeIHypersensitivity 118 TypeIIHypersensitivity 121 (cid:107)(cid:94)(cid:94)(cid:94) (cid:87)(cid:94)(cid:100)(cid:97)(cid:100)(cid:92)(cid:110)(cid:21)(cid:100)(cid:91)(cid:21)(cid:89)(cid:94)(cid:104)(cid:90)(cid:86)(cid:104)(cid:90) CONTENTS TypeIIIHypersensitivity 121 TypeIVDelayedTypeHypersensitivity 122 5.5 Summary 123 FurtherReading 125 Chapter 6: Transfusion and Transplantation 127 6.1 Introduction 127 6.2 BloodandBloodProductsforTransfusion 128 6.3 TheDiscoveryoftheBloodGroupSystems 129 6.4 TheABOBloodGroupSystem(ISBT001) 132 TheAntigensoftheABOSystem 133 AntibodiesoftheABOBloodGroupSystem 134 ConsequencesofABOIncompatibleTransfusions 134 6.5 TheRhBloodGroupSystem(ISBT004) 135 HemolyticDiseaseoftheNewborn 136 6.6 OtherBloodGroupSystems 138 6.7 LaboratoryDeterminationofBloodGroups 139 6.8 RoleofComplementinTransfusionReactions 140 6.9 HazardsofTransfusion 141 TransfusionRelatedAcuteLungInjury 142 IronOverload 142 Alloimmunization 142 GraftversusHostDisease 143 Infections 143 6.10 ScreeningofBloodDonors 143 6.11 TransplantationofSolidTissuesandOrgans 145 ImmunologicalRejectionofTransplants 145 CausesofGraftRejection 146 6.12 TheHLASystem 147 HLATyping 148 6.13 Immunosuppression 150 6.14 HemopoieticStemCellTransplantation 152 BoneMarrowTransplantation 152 PeripheralBloodStemCellTransplantation 153 UmbilicalCordStemCellTransplantation 153 Identi?cationofHemopoieticStemCells 153 6.15 Summary 154 FurtherReading 155 Chapter 7: Disorders of the Endocrine System 157 7.1 Introduction 157 7.2 HormoneProduction 159 7.3 MechanismsofHormonalAction 162 7.4 CausesofEndocrineDisorders 164 7.5 ThePituitaryGland 165 DisordersofPituitaryFunction 167 7.6 GrowthHormoneDisorders 169 DiagnosisandTreatmentofGrowthHormoneDisorders 171 7.7 ThyroidHormoneDisorders 172 DiagnosisandTreatmentofThyroidDisorders 174 7.8 RegulationofBloodGlucose 177 DiabetesMellitus 178 Hypoglycemia 181 7.9 DisordersoftheAdrenalCortex 183 Addison’sDisease 184 Cushing’sSyndrome 185 CongenitalAdrenalHyperplasia 186 (cid:94)(cid:109) (cid:67)(cid:90)(cid:104)(cid:104)(cid:86)(cid:103)(cid:21)(cid:54)(cid:93)(cid:98)(cid:90)(cid:89)(cid:33)(cid:21)(cid:66)(cid:86)(cid:106)(cid:103)(cid:90)(cid:90)(cid:99)(cid:21)(cid:57)(cid:86)(cid:108)(cid:104)(cid:100)(cid:99)(cid:33)(cid:21)(cid:56)(cid:93)(cid:103)(cid:94)(cid:104)(cid:21)(cid:72)(cid:98)(cid:94)(cid:105)(cid:93)(cid:21)(cid:27)(cid:21)(cid:58)(cid:89)(cid:21)(cid:76)(cid:100)(cid:100)(cid:89)