title: Arthritis associated with primary agammaglobulinemia: new clues to its immunopathology.
abstract: 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.
authors.affiliation: Service d'Immuno-Rhumatologie, Hôpital Saint-Eloi, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Sany
authors.forename: C H
authors.initials: CH
authors.lastname: Jorgensen
authors.forename: J M
authors.initials: JM
authors.lastname: Anaya
authors.forename: C
authors.initials: C
authors.lastname: Didry
authors.forename: M
authors.initials: M
authors.lastname: Andary
authors.forename: I
authors.initials: I
authors.lastname: Serre
authors.forename: P
authors.initials: P
authors.lastname: Baldet
mesh_terms: 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
chemical_list: D016827:CD8 Antigens