Internal-Medicine

238 11: Immunology and Allergy
30. (A) Reactive arthritis (e.g., Shigella or Yersinia)
and HLA B27 (Kasper, pp. 1996–1997)
The relationship between HLA antigens
and diseases is not absolute, but rather one of
increased relative risk. The presence of HLA
B27 increases the relative risk of ankylosing
spondylitis by a factor of about 80, of Reiter
syndrome by a factor of 40, and also increases
the likelihood of reactive arthritis. The presence
of HLA DR4 increases the likelihood of
juvenile RA by a factor of 7 and RA by a factor
of 6. The presence of HLA DR3 increases the
likelihood of both SLE and insulin-dependent
diabetes mellitus by a factor of approximately
3.
31. (A) Multiple myeloma and B-cell deficiency/
dysfunction (Kasper, pp. 656–657)
32. (C) Hodgkin’s disease and T-cell deficiency/
dysfunction (Kasper, pp. 654–655)
34. (F) SLE and complement deficiency (Kasper,
pp. 1960–1961)
35. (D) Therapy for hematologic malignancy and
neutropenia (Kasper, p. 635)
36. (B) Ataxia-telangiectasia and both T- and B-cell
dysfunction (Kasper, p. 2423)
Multiple myeloma and chronic lymphocytic
leukemia are two of the more common causes of
B-cell deficiency/dysfunction. Hodgkin’s disease,
AIDS, sarcoidosis, and thymic aplasia or
hypoplasia result in T-lymphocyte depletion/
dysfunction. SLE has been associated with
C3 deficiency, but most severe complement
deficiencies result from inherited disorders.
Ataxiatelangiectasia, common variable hypogammaglobulinemia,
severe combined immunodeficiency,
and Wiskott-Aldrich syndrome have
mixed T- and B-cell deficiency.
33. (A) Chronic lymphocytic leukemia and B-cell
deficiency/dysfunction (Kasper, pp. 648–649)