Arthritis associated with primary agammaglobulinemia: new clues to its immunopathology.
Primary agammaglobulinemia is a rare disorder which is associated with articular symptoms in 11% of patients. Septic arthritis may occur, but often patients complain of chronic oligoarthritis and have a clinical presentation similar to rheumatoid arthritis. We report 2 cases of primary agammaglobulinemia in adults, associated with non-erosive chronic arthritis. Peripheral blood lymphocyte phenotyping showed a predominance of CD8 lymphocytes with a CD4/CD8 ratio < 1. We did not find any abnormalities in cellular immunity. A histological study of the synovium showed chronic synovitis with perivascular CD8 lymphocyte infiltrates. Intravenous infusion of immunoglobulins resulted in a dramatic improvement in the arthritis in both cases. In one patient we noticed a decrease in CD8 lymphocytosis. These results suggest that CD8 lymphocytes are involved in the pathogenesis of the arthritis associated with agammaglobulinemia.
Sany
J
J
Service d'Immuno-Rhumatologie, Hôpital Saint-Eloi, Montpellier, France.
Jorgensen
C H
CH
Anaya
J M
JM
Didry
C
C
Andary
M
M
Serre
I
I
Baldet
P
P
D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications* / Q000276:immunology* / Q000473:pathology; D001168:Arthritis / Q000150:complications* / Q000276:immunology* / Q000473:pathology; D016827:CD8 Antigens / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology / Q000502:physiology; D008297:Male; D013583:Synovial Membrane / Q000473:pathology
D016827:CD8 Antigens