title: Antiribosomal-P protein antibodies in a patient with systemic lupus erythematosus and non-Hodgkin's lymphoma: more than coincidental finding?
abstract: Patients with systemic lupus erythematosus (SLE) are at an increased risk of lymphomas, but mechanisms underlying this association are obscure. Recently, it has been shown that antiribosomal-P protein (anti-P) antibodies cross-react with phospholipids and enhance the production of cytokines which may influence lymphomagenesis. We report a 46-year-old woman who suffered high grade diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) 28 months after the diagnosis of SLE. Development of lymphoma was associated with occurrence of serum monoclonal IgM, and pronounced prolongation of phospholipid-dependent clotting tests. Anti-P IgG antibodies were highly positive both on HEp-2 cells and in ELISA test. Anticardiolipin, anti-beta2 glycoprotein I, and antiprothrombin IgM antibodies have also been found in high concentrations. Complete remission of DLBCL and SLE, with normalisation of clotting tests, and disappearance of M component was achieved with administration of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. The progression of SLE to DLBCL associated with presence of anti-P antibodies has not been previously reported. This association may not be coincidental, but further investigations are required to confirm this hypothesis.
authors.affiliation: Institute of Haematology, Clinical Centre of Serbia, Belgrade, Serbia. pedra@beotel.yu
authors.forename: P
authors.initials: P
authors.lastname: Miljic
authors.forename: B
authors.initials: B
authors.lastname: Bonaci-Nikolic
authors.forename: N
authors.initials: N
authors.lastname: Colovic
authors.forename: T
authors.initials: T
authors.lastname: Terzic
authors.forename: M
authors.initials: M
authors.lastname: Colovic
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D012269:Ribosomal Proteins / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012269:Ribosomal Proteins