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Easton-Jones CA, Estell KE, Magdesian KG. Immune-mediated haemolytic anaemia and thrombocytopenia in 25 adult equids: 1997-2016. Equine Vet J 2020; 53:964-971. [PMID: 33169417 DOI: 10.1111/evj.13384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/21/2020] [Accepted: 10/29/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Information concerning clinical presentation, conditions associated with immune-mediated haemolytic anaemia (IMHA) and thrombocytopenia (IMTP) and outcome in equids is lacking. Previous case reports suggest that immune-mediated disease and neoplasia are associated. OBJECTIVES Characterise the clinical presentation, clinicopathologic data, underlying conditions, treatment and outcome of IMHA and IMTP cases in equids. We hypothesise that IMHA with concurrent thrombocytopenia occurs more often than IMHA or IMTP alone, and that neoplasia is commonly associated with these immune diseases and cases frequently have a poor prognosis. STUDY DESIGN Retrospective case-control study. METHODS Medical records were reviewed from 1997 to 2016. Twenty-five equids were diagnosed with IMHA, IMTP or IMHA with thrombocytopenia by Coombs test or flow cytometry. Controls were equids presented for nonimmune-mediated disease immediately prior to and after study animals. Fisher's exact test was used to compare between groups for categorical variables (P < .05). Results reported as odds ratios (OR) and 95% confidence intervals (CI). Unpaired t test and Mann-Whitney test were used to compare between groups for continuous variables (P < .05). RESULTS Neoplasia incidence was significantly higher in the study population (28%) versus controls (8%) (P = .04). Equids with primary disease were more likely to survive to discharge than equids with secondary disease (8/9 vs 7/16; P = .03; OR = 13.3; 95% CI: 1.3-134.7). Survivors had a significantly lower blood urea nitrogen (BUN) than those that died or were subjected to euthanasia (survivors, 6.1 ± 2.5 mmol/L vs nonsurvivors, 9.9 ± 3.1 mmol/L P = .003). The odds of short-term mortality were higher in horses presenting with increased BUN (OR = 19.5; 95% CI, 1.8-214.1; P = .009). MAIN LIMITATIONS Retrospective nature of the study, small case numbers and limited long-term follow-up. CONCLUSIONS Primary IMHA/IMTP cases have a reasonable prognosis and warrant treatment. Secondary cases have a poor prognosis, and are frequently associated with cancer. BUN may have utility as a prognostic indicator for IMHA/IMTP cases.
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Affiliation(s)
| | - Krista E Estell
- Virginia Tech Marion duPont Scott Equine Medical Center - Internal Medicine, Leesburg, Virginia, USA
| | - K Gary Magdesian
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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2
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Shen F, Li G, Jiang H, Zhao S, Qi F. Primary breast diffuse large B-cell lymphoma in a patient with systemic lupus erythematosus: A case report and review of the literature. Medicine (Baltimore) 2020; 99:e21736. [PMID: 32872060 PMCID: PMC7437807 DOI: 10.1097/md.0000000000021736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Pilot studies have reported that patients with systemic lupus erythematosus (SLE) appear more likely to develop into neoplasia, especially lymphatic hyperplasia diseases. To our knowledge, this is the first case report of the concomitant onset of SLE and primary breast diffuse large B-cell lymphoma (PB-DLBCL). PATIENT CONCERNS We reported an unusual case of the occurrence of primary breast diffuse large B-cell lymphoma in a 25-year-old female patient who had been diagnosed with SLE and treated with immunosuppressive drugs for about 4 years. She presented a 7-week history of a painless mass above the left breast and no history suggestive of any nipple discharge, fever, and weight loss. DIAGNOSIS Ultrasonography of the breast showed that there was 1 mass in the left breast. After breast mass surgical resection, histopathological examinations were performed and revealed that it was primary breast diffuse large B-cell lymphoma. INTERVENTIONS Treatment strategy with vincristine and dexamethasone was used to improve symptoms. However, the patient's renal function deteriorated and the blood potassium rose continuously and she and their family members refused the follow-up treatments. OUTCOMES The patient died 8 months after she was discharged from the hospital. LESSONS PB-DLBCL is a rare occurrence in SLE patients. Therefore, a careful examination is very important in SLE cohort, as activity of the disease and malignancy may mimic each other. Meanwhile, when symptoms cannot be explained or insensitive to treatment, the occurrence of malignant tumors must be highly considered.
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MESH Headings
- Adult
- Breast/pathology
- Breast Neoplasms/complications
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Fatal Outcome
- Female
- Humans
- Kidney Failure, Chronic/etiology
- Lupus Erythematosus, Systemic/complications
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Radiography
- Ultrasonography
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Affiliation(s)
| | - Gang Li
- Department of Orthopedics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong
| | | | | | - Fengjie Qi
- Department of Pathology, Luohu District People's Hospital, Shenzhen, China
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3
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Intestinal Diffuse Large B-Cell Lymphoma in a Patient with Systemic Lupus Erythematosus. Case Rep Gastrointest Med 2020; 2020:7947540. [PMID: 32328319 PMCID: PMC7171631 DOI: 10.1155/2020/7947540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
A 44-year-old Japanese woman with systemic lupus erythematosus (SLE) presented to our hospital with abdominal pain. Radiological and endoscopic examinations led to the diagnosis of diffuse large B-cell lymphoma of the jejunum, which was subsequently resected. Patients with SLE reportedly have an increased risk of non-Hodgkin lymphoma, as demonstrated by our patient. Hence, lymphoma should be considered in the differential diagnosis of neoplastic lesions emerging in SLE patients. In addition, flow cytometry using endoscopically biopsied fragments is useful for the immediate diagnosis of lymphoma, leading to timely and accurate preoperative staging.
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4
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"To be or not to be" for PET in rheumatology. A marriage of love or of convenience? Reumatologia 2017; 55:1-3. [PMID: 28386135 PMCID: PMC5380765 DOI: 10.5114/reum.2017.66679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 02/27/2017] [Indexed: 11/17/2022] Open
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5
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Mayet WJ. [Gastrointestinal tumors. Clinical manifestations of paraneoplastic rheumatic symptoms]. Z Rheumatol 2011; 70:567-72. [PMID: 21858488 DOI: 10.1007/s00393-011-0812-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Paraneoplastic syndromes, as syndromes associated with malignancy, can present unrelated to tumor invasion or metastases. They can occur with varying clinical appearance and are often indistinguishable from idiopathic rheumatic symptoms. Some musculoskeletal disorders are more associated with malignancies. The therapy of rheumatic syndromes can itself have an effect on the tumorigenic process. The clinical severity of paraneoplastic rheumatic symptoms can in many cases aid in the assessment of tumor activity and the response to therapy. While generally an extensive search for occult malignancies in every older rheumatoid patient in cases with no indications of malignancy is not advisable, knowledge of rheumatic symptoms associated with malignancies aids in the important early detection of tumors, while avoiding unnecessary examinations.
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Affiliation(s)
- W-J Mayet
- Zentrum für Innere Medizin, Nordwest Krankenhaus Sanderbusch, Hauptstrasse, Sande, Germany.
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6
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Oh JR, Song HC, Kang SR, Yoo SW, Kim J, Chong A, Min JJ, Bom HS, Lee SS, Park YW. The Clinical Usefulness of (18)F-FDG PET/CT in Patients with Systemic Autoimmune Disease. Nucl Med Mol Imaging 2011; 45:177-84. [PMID: 24900001 DOI: 10.1007/s13139-011-0094-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 06/22/2011] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of (18)F-FDG PET/CT in patients with systemic autoimmune disease. METHODS Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs. RESULTS FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC = 1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P = 0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P = 0.040). CONCLUSIONS PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false-positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.
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Affiliation(s)
- Jong-Ryool Oh
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Su-Woong Yoo
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Ari Chong
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Shin-Seok Lee
- Department of Rheumatology, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Hospital, Gwangju, South Korea
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7
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Silva K, Higa M, Terreri MTDSLRA, Borsato ML, Hilário MOE. Ulcerações orais e genitais como manifestação inicial de leucemia em criança. REVISTA PAULISTA DE PEDIATRIA 2008. [DOI: 10.1590/s0103-05822008000100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
OBJETIVO: Alertar o pediatra para a presença de lesões aftosas orais e úlceras genitais como manifestação inicial de leucemia. DESCRIÇÃO DE CASO: Menina de dez anos de idade, com quadro de úlceras orais e genitais e hipótese diagnóstica de doença de Behçet. Em virtude de leucopenia, foram realizados mielogramas que, inicialmente, demonstraram se tratar de síndrome mielodisplásica e que, posteriormente, evoluiu para leucemia mielóide aguda. COMENTÁRIOS: Os autores alertam para a raridade da associação e para a ausência na literatura de casos na faixa etária pediátrica.
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Abstract
Prostaglandins are ephemeral, infinitesimal signallers self-regulating every cell in the body, including those sub-serving mood and immunity. At first, they were perceived as a master switch, but now are believed to regulate every component of cellular micro-anatomy and physiology, including those of the organelles, cytoskeleton, proteins, enzymes, nucleic acids and mitochondria. Prostaglandins are responsible, paradoxically, for cell function and dysfunction. Excessive prostaglandin synthesis depresses immune function and may induce cancer. An ideal anti-cancer agent would inhibit prostaglandins in such a manner as to shut down the pathogenesis of cancer. In this paper, I will show that antidepressants have such properties.
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Affiliation(s)
- J Lieb
- 127 Cumberland Road, Burlington, Vermont, USA.
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9
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Affiliation(s)
- M Ehrenfeld
- Department of Medicine C, Sheba Medical Center, Tel-Hashomer, Israel
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10
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Lieb J. Antidepressants, prostaglandins and the prevention and treatment of cancer. Med Hypotheses 2007; 69:684-9. [PMID: 17363183 DOI: 10.1016/j.mehy.2007.01.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Accepted: 01/18/2007] [Indexed: 12/12/2022]
Abstract
Among the putative mechanisms of carcinogenesis are up-regulation of cyclooxygenase, the synthesis and expression of oncogenes, viral activation, signal disruption, failed apoptosis, tumor initiation and promotion, angiogenesis, metastasis, immunosuppression, telomerase activity and autoimmunity. All are regulated by prostaglandins. Observable and radiographic regression of cancer has been documented in patients taking non-steroidal, anti-prostaglandin drugs such as indomethacin and ibuprofen. Antidepressants, too, have prostaglandin-inhibiting properties, and in vivo and in vitro evidence of their antineoplastic actions is emerging.
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Papadaki HA, Xylouri I, Katrinakis G, Foudoulakis A, Kritikos HD, Stathopoulos EN, Boumpas DT, Eliopoulos GD. Non-Hodgkin's lymphoma in patients with systemic lupus erythematosus. Leuk Lymphoma 2003; 44:275-9. [PMID: 12688345 DOI: 10.1080/1042819021000030045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Two cases of non-Hodgkin's lymphoma (NHL) associated with systemic lupus erythematosus (SLE) are described. Patient-1 was a 65-year-old woman in whom SLE and diffuse large B-cell lymphoma were concurrently diagnosed. The patient presented with low-grade fever, butterfly rash, arthritis and generalized lymphadenopathy without splenomegaly or bone marrow involvement. Complete remission of NHL and SLE was achieved with cyclophosphamide, adriamycin, vincristine and prednisone. Patient-2 was a 56-year-old woman in whom SLE had been diagnosed 14 years earlier. The patient presented with low-grade fever, bulky splenomegaly without lymphadenopathy, IgMA paraproteinemia, and expansion of a monoclonal CD19+/CD22+ lambda-type B-cell population in both bone marrow and peripheral blood. Diagnosis of a lympho-plasmacytoid lymphoma was established histologically after splenectomy. A partial remission of the neoplasm was achieved with cyclophosphamide, vincristine and prednisone. We suggest that the development of NHLs in patients with SLE may not be coincidental and we recommend the search for NHL in cases of SLE with prominent lymphadenopathy, massive splenomegaly or expansion of a monoclonal CD19+/CD22+ B-cell population.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Female
- Humans
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/diagnosis
- Lupus Erythematosus, Systemic/therapy
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/etiology
- Lymphoma, Non-Hodgkin/therapy
- Middle Aged
- Remission Induction
- Splenectomy
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Affiliation(s)
- H A Papadaki
- Department of Haematology, University of Crete School of Medicine, University Hospital of Heraklion, PO Box 1352, Crete, Greece.
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12
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Nived O, Bengtsson A, Jönsen A, Sturfelt G, Olsson H. Malignancies during follow-up in an epidemiologically defined systemic lupus erythematosus inception cohort in southern Sweden. Lupus 2002; 10:500-4. [PMID: 11480849 DOI: 10.1191/096120301678416079] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this study was to identify all malignancies in an inception cohort of SLE patients in southern Sweden and compare with the observed frequencies and spectrum of malignancies in the general population. All adult incidence cases of SLE in a defined population during the period 1981-1996 were retrieved from a prospective database and the cases were followed to endpoint or through 1998. The SLE cohort registry was aggregated with the National Cancer Registry to identify all malignancies by date, type and outcome. Standardized morbidity rates (SMR) were calculated based on the sex- and age-matched general population of the region. Sixteen malignancies occurred in 13 patients out of a total of 116 SLE patients observed for 1086 patient-years. The SMR for all cancers detected was 2.24 (confidence interval 0.6-5.7) for males and 1.02 (confidence interval 0.4-2.1) for females and thus indicative of no general increase in malignancies. However, the SMR for non-Hodgkin lymphoma was 11.63 (confidence interval 1.4-42.0), for pulmonary cancer 5.55 (confidence interval 0.7-20.1) and prostatic cancer 6.41 (confidence interval 1.3-18.7) all significantly increased. The increase in prostatic carcinoma disappeared when only cases occurring after a latency period of 3y after SLE diagnosis were included. In this comprehensive inception cohort of SLE no increase in relative risk of malignancy overall was found, but the frequencies of non-Hodgkin lymphoma and pulmonary cancer were increased, possibly also the frequency of prostatic carcinoma.
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Affiliation(s)
- O Nived
- Department of Rheumatology, University Hospital, Lund, Sweden.
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13
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Lieb J. Antidepressants, eicosanoids and the prevention and treatment of cancer. A review. Prostaglandins Leukot Essent Fatty Acids 2001; 65:233-9. [PMID: 11993714 DOI: 10.1054/plef.2001.0319] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Among the mechanisms of carcinogenesis are oncogene synthesis and expression, upregulation of cyclooxygenase, accelerated cell replication, failed apoptosis, viral activation, disruption of signaling pathways, autoimmunity, immunosuppression, angiogenesis and metastasis. All fall within the orbit of eicosanoids and the enzymes that synthesize them. Antidepressants may be of benefit in the prevention and treatment of cancer, as they inhibit the synthesis, antagonize the actions and accelerate the degradation of such eicosanoids as prostaglandins and thromboxanes.
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14
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Naschitz JE, Rosner I, Rozenbaum M, Zuckerman E, Yeshurun D. Rheumatic syndromes: clues to occult neoplasia. Semin Arthritis Rheum 1999; 29:43-55. [PMID: 10468414 DOI: 10.1016/s0049-0172(99)80037-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Rheumatic disorders associated with cancer include a variety of conditions, most of which have no features distinguishing them from idiopathic rheumatic disorders. It is generally held that an extensive search for occult malignancy in most rheumatic syndromes is not recommended unless accompanied by specific findings suggestive of malignancy. The objective of this review are to identify rheumatic syndromes associated with cancer, to call attention to features that may suggest the presence of a hidden cancer, and to examine the role to additional clinical and laboratory data as clues to the possible neoplastic cause of those syndromes. METHODS A MEDLINE search of the literature dealing with cancer-associated rheumatic syndromes was conducted. RESULTS Review of the literature identified significant progress in this area. First, the association of malignancy with certain rheumatic syndromes was convincingly established, such as asymmetric polyarthritis presenting in the elderly with an explosive onset, rheumatoid arthritis with monoclonal gammopathy, Sjögren's syndrome with monoclonality, hypertrophic osteoarthropathy, dermatomyositis, polymyalgia rheumatica with atypical features, Lambert-Eaton myasthenic syndrome, palmar fasciitis and arthritis, eosinophilic fasciitis poorly responsive to corticosteroid therapy, erythema nodosum lasting more than 6 months, and onset of Raynaud's phenomenon or cutaneous leukocytoclastic vasculitis after age 50 years. Second, the list of cancer-associated rheumatic syndromes was extended by including additional entities such as benign edematous polysynovitis, sacroiliitis, adult-onset Still's disease, dermatomyositis sine myositis, systemic sclerosis, Sweet's syndrome, osteomalacia, skeletal hyperostosis, antiphospholipid syndrome, and essential mixed cryoglobulinemia. Third, evidence was provided substantiating that certain long-standing rheumatic syndromes, in particular rheumatoid arthritis, Felty's syndrome, Sjögren's syndrome, dermatomyositis, systemic sclerosis, systemic lupus erythematosus, and temporal arteritis behave like "premalignant conditions." Fourth, it was shown that the recognized tumor markers alpha-fetoprotein, prostate-specific antigen, CA-125, CA 19-9, and CA-3 have low sensitivity and specificity in screening for occult cancer in a population of rheumatic patients, whereas the presence of a monoclonal gammopathy in rheumatoid arthritis and the monoclonal antibody 17-109 in Sjögren's syndrome are reliable signs of malignant transformation. CONCLUSIONS The presence of specific rheumatic syndromes and certain clinical and laboratory findings may justify a workup for hidden cancer. Studies of the epidemiology of the cancer-associated rheumatic syndromes and evaluation of the validity of aforementioned clues in prospective studies are goals for future investigations.
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Affiliation(s)
- J E Naschitz
- Department of Internal Medicine A, Bnai Zion Medical Center and Bruce Rappaport, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
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15
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Abstract
Intravenous (i.v.) Ig is the human serum Ig fraction that is mainly composed of IgG prepared from plasma pools of over 15,000 healthy blood donors and is suitable for i.v. use. High-dose i.v. Ig is currently used to treat patients with diverse autoimmune conditions. Autoimmunity and malignancy co-exist frequently, and share etiological and pathological mechanisms. Since the two diseases are similarly treated, we studied the efficacy of i.v. Ig as a treatment for malignant conditions. The administration of i.v. Ig to mice inoculated i.v. with melanoma or sarcoma cells induced a statistically significant inhibition of metastatic lung foci and prolongation of survival time. Similar results were seen with SCID mice inoculated with SK-28 human melanoma cells. In a different model, melanoma was induced in the foot pad, followed by leg amputation, after the development of the tumor lesion. A lower number of melanoma recurrences and prolongation of survival time were demonstrated in the i.v. Ig-treated groups. In vitro studies revealed that i.v. Ig was found to stimulate the production of IL-12, an anti-tumor and anti-angiogenic cytokine. Moreover, it enhanced NK cell activity, thus explaining its beneficial effect in SCID mice (which lack B and T but possess NK cells). The results indicate that i.v. Ig acts as an anti-tumor agent. Since it has only minor side effects and is used extensively for other clinical conditions, i.v. Ig may be considered as a potential therapy for the prevention of tumor spread in humans.
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MESH Headings
- Animals
- Disease Models, Animal
- Humans
- Immunization, Passive
- Immunoglobulins, Intravenous/therapeutic use
- Interleukin-2/biosynthesis
- Killer Cells, Natural/immunology
- Lung Neoplasms/secondary
- Melanoma, Experimental/pathology
- Melanoma, Experimental/secondary
- Melanoma, Experimental/surgery
- Melanoma, Experimental/therapy
- Mice
- Mice, Inbred C57BL
- Mice, SCID
- Neoplasm Recurrence, Local/prevention & control
- Sarcoma, Experimental/pathology
- Sarcoma, Experimental/secondary
- Sarcoma, Experimental/surgery
- Sarcoma, Experimental/therapy
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Affiliation(s)
- Y Shoenfeld
- Research Unit of Autoimmune Diseases, Department of Medicine 'B', Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel-Hashomer 52621, Israel
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16
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Konstandoulakis MM, Syrigos KN, Leandros M, Charalabopoulos A, Manouras A, Golematis BC. Autoantibodies in the serum of patients with gastric cancer: their prognostic importance. Hybridoma (Larchmt) 1998; 17:431-5. [PMID: 9873988 DOI: 10.1089/hyb.1998.17.431] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To evaluate the presence in serum and the clinical relevance of several antinuclear autoantibodies, we investigated 31 patients with initially diagnosed gastric cancer and 40 age-matched healthy controls. Autoantibodies against ssDNA, dsDNA, cardiolipin, actin, myosin, tropomyosin, GM1, GD1b and GT3 gangliosides, were detected with an enzyme-linked immunoassay (ELISA). Anti-ssDNA, anti-actin, anti-GM1 and anti-GD1b antibodies were detected in the serum of 11 (p = 0.001), 8 (p = 0.02), 11 (p = 0.001), and 9 (p = 0.008) patients with gastric cancer, respectively. There was no significant difference between patients with cancer and the control group, as far as the other autoantibodies were concerned. Most of the patients (90%) had autoantibodies against at least one of the antigens examined. Patients with anti-ssDNA, anti-actin, anti-GM1 and anti-GD1b antibodies were less likely to survive than the patients being negative to the above autoantibodies: the figures are 1 of 11 (9%) compared with 4 of 20 (20%); 1 of 8 (13%) compared with 5 of 23 (22%); 1 of 11 (9%) compared with 4 of 20 (20%); and 1 of 9 (11%) compared with 4 of 22 (18%), respectively. Our findings suggest that 4 of the 9 autoantibodies that we assayed are significantly more likely to be found in serum of patients with gastric cancer, indicating that the immune system has a role in the process of the malignant disease. If our results are confirmed by forthcoming studies, some of the immunological variables that we examined could be used as markers of prognostic value in patients with gastric cancer.
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Affiliation(s)
- M M Konstandoulakis
- 1st Department of Propaedeutic Surgery, Athens Medical School, Hippokration Hospital, Greece
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17
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Abstract
A nasopharyngeal carcinoma was diagnosed in a 37-year-old man with a two year history of dermatomyositis. The physical and laboratory examinations excluded further medical problems. To our knowledge, this is the first case of dermatomyositis associated with nasopharyngeal carcinoma in a white Israeli Jewish patient.
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Affiliation(s)
- Z Abraham
- Department of Dermatology, Reish Policlinic, Haifa, Israel
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18
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Abstract
Neoral (a microemulsion-based formulation) is an immunomodulator that possesses a more predictable and improved absorption than the conventional oral formulation (Sandimmun). The increased bioavailability of Neoral could result in improved efficacy. The pharmacokinetics of cyclosporin and efficacy of cyclosporin in rheumatoid arthritis are reviewed in this article. Current guidelines for the use of Neoral in the treatment of rheumatoid arthritis patients are outlined.
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Affiliation(s)
- A Cranney
- Department of Medicine, University of Ottawa, Ontario, Canada
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19
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Abu-Shakra M, Gladman DD, Urowitz MB. Malignancy in systemic lupus erythematosus. ARTHRITIS AND RHEUMATISM 1996; 39:1050-4. [PMID: 8651970 DOI: 10.1002/art.1780390625] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To estimate the risk of cancer in patients with systemic lupus erythematosus (SLE). METHODS Patients with SLE (n = 724) have been followed prospectively, for 24 years, at the University of Toronto Lupus Clinic. The diagnosis of cancer was confirmed by histologic or autopsy reports. Standardized rates of cancer and standardized incidence rates (SIR) (ratio of observed-to-expected cancers) were used to estimate the risk for cancers. RESULTS Twenty-four cancers were identified in 23 SLE patients (3.2%) during 7,233 patient-years of followup. Compared with the Ontario population, the overall estimated risk for all cancers was not increased in the lupus cohort (SIR 1.08, 95% confidence interval 0.70-1.62). A 4.1-fold increased risk for hematologic cancers was observed, due mainly to an increased risk of non-Hodgkin's lymphoma. The risk for cancer was significantly lower in the SLE cohort compared with patients with rheumatoid arthritis (RA) and systemic sclerosis (SSc). CONCLUSION SLE is associated with a lower risk of all cancers compared with RA and SSc, but an increased risk for non-Hodgkin's lymphoma compared with the general population.
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Affiliation(s)
- M Abu-Shakra
- University of Toronto Lupus Clinic, Ontario, Canada
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20
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Villarreal GM, Alcocer-Varela J, Llorente L. Differential interleukin (IL)-10 and IL-13 gene expression in vivo in salivary glands and peripheral blood mononuclear cells from patients with primary Sjögren's syndrome. Immunol Lett 1996; 49:105-9. [PMID: 8964596 DOI: 10.1016/0165-2478(95)02490-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Primary Sjögren's syndrome (PSS) is an autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine glands, B cell hyperactivity and autoantibody production. The aim of this study was to determine the presence of IL-10 and IL-13 in this disease. We studied the IL-10 and IL-13 gene expression in vivo by peripheral blood mononuclear cells and minor salivary glands from PSS patients. We found a high expression of the IL-10 gene and its product by their peripheral blood mononuclear cells (PBMC) as well as by their salivary glands. Peripheral blood B cells and monocytes were responsible for 89% of total IL-10 secretion. IL-13 gene expression was not observed in PBMNC from either PSS patients or healthy controls, and was confined to PSS salivary glands. Our results suggest that IL-10 and IL-13 contribute to the pathogenesis of PSS and might explain the B cell abnormalities and the development of lymphoma observed in this autoimmune disease.
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Affiliation(s)
- G M Villarreal
- Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, Tlalpan, México
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21
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22
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Abstract
In order to obtain valid data on the pattern, frequency and prognostic significance of autoimmune derangements in non-Hodgkin's lymphoma (NHL) we studied 626 consecutive adult NHL patients participating in a population-based lymphoma registry. A total of 86 patients, corresponding to 13.7%, showed autoimmune phenomena (AP). Of these, 7.8% exhibited clinical autoimmune phenomena (CAP), and 5.9% showed immunohaematological phenomena (IHP). The distribution of histological subgroups of NHL in the AP and non-AP patients was similar. The same holds true for the CAP and IHP patients. A slight, non-significant overrepresentation of NHL, T-cell phenotype was found in patients with AP. CAP preceded the diagnosis of NHL in most patients, whereas IHP was associated with active lymphoma disease. AP as a whole did not predict for time to complete response, time to relapse or for survival. The finding that IHP patients relapsed earlier than CAP patients was not reflected in a significant difference in survival.
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Affiliation(s)
- K Grønbaek
- Department of Haematology, Odense University Hospital, Denmark
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23
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Abstract
BACKGROUND The frequency with which rheumatic disorders occur when malignant neoplasms first present is unknown, and the significance of rheumatic conditions as cancer markers is unappreciated. METHODS Patients admitted to a medical ward of a general hospital (Bnai Zion Medical Center, Haifa, Israel) during a 10-year period were surveyed. The frequency of the diagnostic evaluation of rheumatic disorders resulting in uncovering occult neoplasia at the time of index hospitalization and during the 2-year follow-up period was assessed. RESULTS The incidence of occult cancer among patients admitted to a general medical ward with previously unclarified rheumatic disorders was 23.1%. Seventy-two percent of the group of patients with rheumatic diseases and occult cancer were male; 69% with rheumatic disease without cancer (control group) were female. The median age in the group with occult cancer was an average of 10 years older than the group without cancer, 67 versus 57 years (P < 0.001). Weight loss or anemia occurred in 52% of the group with occult cancer and in 37.3% of the control cases (not significant). Typically, there were no distinguishing features of the rheumatic syndromes suggesting the coexistence of cancer. In 19 of 25 cases, the malignancy was uncovered by routine examinations. In four instances, neoplasia was not immediately apparent but was identified in a specific search. In two cases, no search for malignancy initially was undertaken, and Hodgkin's lymphoma was diagnosed 6 and 12 months later. In 9 of 25 cases, long term remission of neoplasia was achieved by cancer therapy with improvement of rheumatic manifestations coinciding with regression. CONCLUSIONS A significant number of patients who are referred to a general medical ward for evaluation of previously unclassified rheumatic disorders may be found to have a previously undetected malignancy. For most patients, the symptoms of cancer are found by routine physical and laboratory examinations. The importance of the association of rheumatic disorders and malignancy requires greater awareness, appreciation, and clinical study.
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Affiliation(s)
- J E Naschitz
- Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel
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24
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Nashitz JE, Rosner I, Rozenbaum M, Elias N, Yeshurun D. Cancer-associated rheumatic disorders: clues to occult neoplasia. Semin Arthritis Rheum 1995; 24:231-41. [PMID: 7740303 DOI: 10.1016/s0049-0172(95)80033-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Interest in the rheumatologic manifestations of cancer is related in part to practical considerations, ie, earlier cancer diagnosis is possible through enhanced awareness of cancer-associated rheumatic syndromes. The spectrum of rheumatic disorders associated with cancer includes over 30 conditions, including hypertrophic osteoarthropathy, polymyalgia rheumatica, palmar fasciitis with polyarthritis, most autoimmune connective tissue diseases, and the more recently described antiphospholipid syndrome. It is generally held that extensive search for occult malignancy in most rheumatologic disorders is not cost efficient and not recommended unless accompanied by specific findings suggestive of malignancy. The present article discusses the supplementary findings that may justify malignancy evaluation.
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Affiliation(s)
- J E Nashitz
- Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel
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25
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Casoli P, Tumiati B. Acute myelogenous leukemia in a rheumatoid arthritis patient under cyclosporine A therapy. Clin Rheumatol 1994; 13:646-7. [PMID: 7697973 DOI: 10.1007/bf02243012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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26
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Affiliation(s)
- E Teske
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, University of Utrecht, The Netherlands
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27
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Affiliation(s)
- M S Doutre
- Department of Dermatology, Centre Hospitalier of Bordeaux, France
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28
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Syrigos KN, Konstantoulakis MM, Constantoulakis M, Marafelia P, Koutras D, Golematis BC. Thyroid autoantibodies and thyroid function in patients with gastric cancer. Acta Oncol 1994; 33:905-7. [PMID: 7818923 DOI: 10.3109/02841869409098454] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Antibodies against thyroid antigens are commonly found in patients with chronic gastritis type B (20-30%) and pernicious anaemia (50%), two disorders that predispose to gastric cancer. In addition, thyroid disease in increased incidence has been reported in breast and in colon cancer. In order to determine a) the incidence of antithyroid antibodies (ATA) in gastric cancer, b) the thyroid function in patients with ATA and c) the correlation between ATA and the presence of chronic gastritis, we examined the sera of 32 patients with gastric cancer (GC) for the presence of antithyroglobulin and antimicrosomal antibodies. T3, T4 and TSH values were also measured. The sera of 36 patients with malignant tumours of the GI tract other than stomach (OMT) and of 40 healthy blood donors were used as controls. Three of the 32 GC patients had antithyroglobulin antibodies, 4 had antimicrosomal and one had both types. Of the eight patients with ATA (25%) only two had hypothyroidism and another two histologically diagnosed chronic gastritis. Three sera of the healthy controls and one of the OMT had also antithyroid antibodies. To conclude, a significant number of patients with GC had ATA as compared to controls (p < 0.01) but the presence of ATA did not necessarily indicate an abnormality of thyroid function. The presence of antibodies did not correlate with chronic gastritis type B.
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Affiliation(s)
- K N Syrigos
- 1st Dept. of Propaedeutic Surgery, Medical School, Athens University, Greece
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29
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Glück Z, Kutsherowsky M, Abraham Z, Galper I. Dermatomyositis, carcinoma of colon and meningioma in the same patient. J Dermatol 1993; 20:719-22. [PMID: 8300944 DOI: 10.1111/j.1346-8138.1993.tb01371.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Dermatomyositis and carcinoma of colon were diagnosed in a 66-year-old woman. Meticulous physical examination excluded further systemic or cutaneous involvement. The musculocutaneous disorders responded well to daily oral corticosteroid, and the malignant tumor was totally removed surgically. After a seven-year follow-up of actual dermatomyositis controlled by maintenance doses of prednisone ranging from 5 to 15 mg daily, the patient developed a meningioma. Current concepts and data regarding various aspects of the combination between dermatomyositis and tumors are discussed. To our knowledge, this is the first reported case of meningioma associated with dermatomyositis.
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Affiliation(s)
- Z Glück
- Department of Geriatrics, Barzilai Medical Center, Ashkelon, Israel
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30
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Abstract
BACKGROUND Autoimmune diseases and neoplasia have been associated as occurring simultaneously in individuals. This study evaluated the association between the simultaneous occurrence of canine lymphoma and various immune-mediated diseases. METHODS The Veterinary Medical Data Program, a national disease data registry for veterinary schools, was examined. The following immune-mediated disease categories were evaluated: lupus disorders, pemphigus disorders, autoimmune polyarthritis, immune-mediated hemolytic anemia, and immune-mediated thrombocytopenia. Odds ratios with 99% confidence intervals were calculated for the occurrence of lymphoma and each of the immune-mediated disorder categories. RESULTS Only dogs with immune-mediated thrombocytopenia had a statistically significantly increased odds ratio (5.61; 99% confidence interval, 4.16-7.57) for the occurrence of lymphoma versus the general population. This association still was observed for immune-mediated thrombocytopenia when stratified by age, sex, and neutering status. CONCLUSION Dogs with immune-mediated thrombocytopenia had a greater occurrence of lymphoma than dogs without immune-mediated thrombocytopenia.
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Affiliation(s)
- E T Keller
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison 53706
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31
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Lugassy G, Lishner M, Polliack A. Systemic lupus erythematosus and chronic lymphocytic leukemia: rare coexistence in three patients, with comments on pathogenesis. Leuk Lymphoma 1992; 8:243-5. [PMID: 1283357 DOI: 10.3109/10428199209054911] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We describe three patients with coexistent chronic lymphatic leukemia (CLL) and systemic lupus erythematosus (SLE). In two patients, the CLL was present before or coexistent with the SLE when the SLE was diagnosed, while in the third, the CLL developed 5 years after the diagnosis of SLE was first made. Although the association of autoimmune diseases and lymphoproliferative disorders is well established, only a few patients with coexistent CLL and concomitant SLE have been reported. The possible pathogenesis of this rare association is discussed.
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MESH Headings
- Adult
- Aged
- Animals
- Antigens, CD/analysis
- Autoimmune Diseases/complications
- Autoimmune Diseases/pathology
- Autoimmunity
- B-Lymphocyte Subsets/pathology
- CD5 Antigens
- Carcinoma
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/pathology
- Male
- Mice
- Mice, Inbred NZB
- Models, Biological
- Neoplasms, Multiple Primary
- Stomach Neoplasms
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Affiliation(s)
- G Lugassy
- Institute of Hematology, Barzilai Medical Center, Ashkelon, Israel
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32
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Abstract
Dermatomyositis developed suddenly in a diabetic patient with CREST syndrome after the removal of a malignant tumor. Scrupulous physical examination excluded further systemic or cutaneous involvement. We raise certain still unsolved aspects regarding the association between dermatomyositis and neoplastic disorders.
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Affiliation(s)
- Z Abraham
- Department of Dermatology, Reish Policlinic, Haifa, Israel
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33
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Santana V, Rose NR. Neoplastic lymphoproliferation in autoimmune disease: an updated review. CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY 1992; 63:205-13. [PMID: 1535838 DOI: 10.1016/0090-1229(92)90224-c] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- V Santana
- Department of Immunology and Infectious Diseases, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205
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34
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Abstract
Sera of 84 patients with Hodgkin's disease (HD) and 55 patients with non-Hodgkin's lymphoma (NHL) were examined for the presence of autoantibodies to ssDNA, dsDNA, Poly (I), Poly (G), cardiolipin, histones, RNP. Sm, Ro (SS/A), La (SS/B) and the common anti-DNA idiotype (16/6) using an enzyme-linked immunosorbent assay (ELISA). Anti-ssDNA antibodies were detected in the sera of 20 patients with lymphoma (23.8%), more among those with NHL than HD (16 vs. 4 patients p < 0.01). Anti-RNP and anti-Sm antibodies were found in 16 (21.7%) and 14 lymphoma patients (20%) respectively, significantly more than in the controls (p < 0.05) in both antibodies). These findings remained valid following subgrouping of the patients into those with HD and NHL. With all the other autoantibodies examined no significant difference could be observed in the incidence between lymphoma patients and controls. These results differ from our previous survey carried out on sera of patients with solid tumors in whom no increased frequency of any of the autoantibodies could be determined. In view of the evidence suggesting an increased risk of lymphoma in a number of autoimmune diseases our results extend this relationship to an increased incidence of autoantibodies among patients with lymphoma.
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Affiliation(s)
- M Swissa
- Research Unit of Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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35
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Abstract
The relationship between rheumatoid factor (RF) and cancer was studied during a long-term health survey done in the Reykjavik area of Iceland since 1967. A total of 16,299 blood samples from 13,858 persons attending this health survey between 1974 and 1983 were screened for the presence of RF. In 1987, RF-positive participants in this study (n = 270) and matched RF-negative control subjects (n = 223) were evaluated for incidence and prognosis of cancer with information obtained from the comprehensive Icelandic Cancer Registry. The average observation time for this cohort was 9.3 years. Participants with raised immunoglobulin A RF in their original blood sample showed an increased risk of having cancer compared with both other members of the cohort and the national cancer incidence. Their total mortality was also higher during the study period. By contrast, patients with cancer and elevated immunoglobulin M RF before the diagnosis of cancer were more likely to survive than those who were immunoglobulin M RF negative. Cancer incidence in the RF-negative control group was not different from the expected national incidence of cancer in Iceland for that age group. It is suggested that elevation of immunoglobulin A RF is an adverse phenomenon in relation to cancer; elevation of immunoglobulin M RF is associated with a favorable prognosis.
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Affiliation(s)
- T Jónsson
- Department of Immunology, National University Hospital, Reykjavik, Iceland
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36
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Pettersson T, Pukkala E, Teppo L, Friman C. Increased risk of cancer in patients with systemic lupus erythematosus. Ann Rheum Dis 1992; 51:437-9. [PMID: 1586239 PMCID: PMC1004687 DOI: 10.1136/ard.51.4.437] [Citation(s) in RCA: 151] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To evaluate the risk of cancer in patients with systemic lupus erythematosus (SLE) a series of 205 consecutive patients (182 women and 23 men) were followed up for cancer through the files of the Finnish Cancer Registry. The follow up consisted of a total of 2340 person years. Fifteen cancers were diagnosed against 5.7 expected (relative risk (RR) 2.6, 95% confidence interval (CI) 1.5 to 4.4). Among the women there were four non-Hodgkin's lymphomas against 0.09 expected (RR 44, CI 11.9 to 111) and two soft tissue sarcomas against 0.04 expected (RR 49, CI 6.0 to 177). When evaluated by a case control study previous treatment with cytostatic drugs showed no influence on the occurrence of cancer in this series of patients with SLE.
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Affiliation(s)
- T Pettersson
- Fourth Department of Medicine, Helsinki University Central Hospital, Finland
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37
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38
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Abstract
One hundred sixty-four sera samples of patients with malignant diseases were analyzed for the presence of autoantibodies to ssDNA, dsDNA, poly(I), Poly(G), cardiolipin, histones, RNP, Sm, Ro(SSA), and La (SSB). No distinction could be made between these patients and a comparative group composed of age-adjusted healthy subjects when measuring antibody levels to these autoantigens by the ELISA technique. This finding remained valid after further subgrouping of the patients according to age, sex, and histologic origin of the tumor. The authors conclude that in contrast to the known clinical coexistence of neoplasia in autoimmune states, there is no increased incidence of antinuclear autoantibodies in malignant conditions.
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Affiliation(s)
- M Swissa
- Research Unit of Autoimmune Diseases, Corob Research Center, Tel-Hashomer, Israel
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39
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Thomas CR, Rest EB, Brown CR. Rheumatologic manifestations of malignancy. MEDICAL AND PEDIATRIC ONCOLOGY 1990; 18:146-58. [PMID: 2406554 DOI: 10.1002/mpo.2950180212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The relationship between rheumatologic syndromes and cancer covers a very broad array of both common and distinctly rare manifestations. This discussion has outlined some of the known relationships that do exist. A high index of suspicion by both the primary care physician and subspecialist will enhance the probability of detecting cancer in the patient who may present with rheumatologic complaints.
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Affiliation(s)
- C R Thomas
- Department of Internal Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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