Question

Explain pathophysiological processes behind how rheumatic arthritis may lead, after many years, to shortness of breath.

Answer 1

The rheumatic arthritis occurs due to the pharyngeal infections by the causative agent streptococcus pyrogens in individuals which has genetic susceptibility to this disease.The pharyngeal infections lead to activation of innate immune system and thus generation of the T and B cells occurs against the streptococcus pyrogens antigen.The activation of CD4+ T cells and generation of IgG and IgM antibodies by B cells which causes the tissue injury. This occurs due to the structural resemblance between the streptococcus pyogens and human proteins creates the cross reactions of antibodies against human proteins.In short, the cell mediated immunity and immune complex formation is the pathophysiological process/response.Therefore, the cross reactive responses result into rheumatoid fever, hypersensitivity pneumonitis and in acute cases, it causes shortness of breath and cough and fever.