Prevalence of autoantibodies (ANA, anti ds-DNA, ENA, IMF) and rheumatic syndromes in patients with lymphoproliferative diseases.
OBJECTIVE
In the development of rheumatic syndromes as well as of lymphoproliferative disorders it is probable that there are common genetic, environmental and immunoregulatory pathogenetic mechanisms. The purpose of this study was to determine the frequency of simultaneous presentation of both lymphoma or other lymphoproliferative diseases, and rheumatic syndromes.


METHODS
In this study included were all patients with lymphoproliferative diseases (1920 patients) followed at our hospital during the last 5 years. 312/1920 (16.2%) patients presented with non-Hodgkin's lymphoma (NHL), 645/1920 (33.5%) had myeloma, 558/1920 (29%) had leukemia and miscellaneous other hematological malignancies (Hodgkin's lymphoma, cryoglogulinaemia etc) had 405/1920 patients (21%). Antinuclear antibodies (ANA), ribosome P and intermediate filament antibodies (IMF) were measured by immunofluorescence (IF). Anti-double-stranded DNA (ds-DNA) antibodies and extractable nuclear antigens (ENA: Sm, RNP, SSA, SSB, Scl70) were measured by ELISA and the rheumatoid factor (RF) by nephelometry.


RESULTS
388/1920 (4.6%) patients were ANA positive (antibody titres>1/160). On the other hand, clinical symptoms attributed autoimmune diseases (arthralgias, morning stiffness etc) plus autoantibodies other than ANA were present only in 8/312 (2.56%) patients with NHL, among them one with anti-cardiolipin antibodies. It is interesting that from these 8 patients, 3 had MALT lymphoma and 3 diffuse B-cell large cell lymphoma. Also, we detected anti-IMF and IgM and lgG anti-CMV antibodies in 2/312 (0.42%) patients with NHL.


CONCLUSIONS
We conclude that the simultaneous presence of lymphoproliferative diseases and rheumatic syndromes are more frequent among lymphoma patients than in other lymphoproliferative diseases. Therefore, the screening of antibodies in NHL patients may be useful for the discovery and the treatment of an underlying autoimmune disease.
Chloraki-Bobota
A
A
Departments of Immunology, Metaxa Cancer Hospital, Piraeus, Greece. dpsd00045@syros.aegean.gr
Megalakaki
C
C
Repousis
P
P
Chalkiopoulou
Ir
I
Lalaki
I
I
Trafalis
D T
DT
Athanassiou
A E
AE
Mitsouli-Mentzikof
Chr
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood*; D034961:Antigens, Nuclear / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D004247:DNA / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007381:Intermediate Filament Proteins / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000276:immunology*; D008875:Middle Aged; D015995:Prevalence; D012216:Rheumatic Diseases / Q000276:immunology*; D012680:Sensitivity and Specificity; D013577:Syndrome
D000974:Antibodies, Antinuclear; D034961:Antigens, Nuclear; D001323:Autoantibodies; D007381:Intermediate Filament Proteins; D004247:DNA