Elevated serum cytokine levels in a rheumatoid arthritis patient with large granular lymphocyte syndrome

Ozaki, Masatoshi; Kawabe, Yojiro; Nakamura, Hiroshi; Migita, Kiyoshi; Kawakami, Ayako; Tsukazaki, Katsumi; Eguchi, Kei

doi:10.1093/rheumatology/40.5.592

Cited by 11 publications

(8 citation statements)

References 3 publications

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“…An extensive review of previous reports shows that a total of 24 cases with γ δ T‐LDGL, including our report, have been identified (4, 5, 14, 22–24, 34–45). Fourteen of them were Japanese, although no cases were reported from other parts of Asia.…”

Section: Discussionmentioning

confidence: 64%

Lymphoproliferative disease of granular lymphocytes with T‐cell receptor gamma delta‐positive phenotype: restricted usage of T‐cell receptor gamma and delta subunit genes

Makishima

Ishida

Saitô

et al. 2003

European J of Haematology

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Lymphoproliferative disease of granular lymphocytes (LDGL) is characterized by more than 0.5 x 109/L of proliferating granular lymphocytes in the peripheral blood. Because of its rarity, the characteristics of LDGL with T-cell receptor (TCR) gammadelta phenotype (gammadeltaT-LDGL) have not yet been identified. This report describes the clinical, hematological, and immunological findings of four patients with this disease. In two cases, the clinical course was indolent and the other two patients required various therapies. The cells had a common immunophenotype: CD3+, CD4-, CD16+, CD56-, CD57-, CD122-, TCR-gammadelta+, and three were CD8-positive. The immunopurified TCR-gammadelta cells from the patients expressed only Vgamma9 and Vdelta1. Spectratyping and sequencing showed mono- or oligoclonality for TCRgamma and TCRdelta subunit genes. Soluble Fas ligand in sera was significantly elevated in all patients. These findings suggest that gammadeltaT-LDGL qualifies as a distinct disease entity.

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Section: Discussionmentioning

confidence: 64%

Lymphoproliferative disease of granular lymphocytes with T‐cell receptor gamma delta‐positive phenotype: restricted usage of T‐cell receptor gamma and delta subunit genes

Makishima

Ishida

Saitô

et al. 2003

European J of Haematology

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“…To the best of our knowledge, this is the first case report on a patient with SS and CNKL, although a few cases of large granular lymphocyte syndrome associated with rheumatoid arthritis have been described (4,5). Previously, it was reported that CD16 expression by NK cells was decreased in SS and circulating anti-CD16 antibodies has been recognized in sera from patients with SS (6)…”

Section: Discussionmentioning

confidence: 92%

Successful Treatment of Primary Sjoegren's Syndrome with Chronic Natural Killer Lymphocytosis by High-Dose Prednisolone and Indomethacin Farnesil

et al. 2007

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We report a patient with Sjögren's syndrome and chronic natural killer lymphocytosis, who developed severe neutropenia, autoimmune hemolytic anemia, and immune thrombocytopenia. High-dose prednisolone therapy improved the hemolytic anemia and thrombocytopenia, but not the CD16(+) CD56(-) NK lymphocytosis completely. Interestingly, indomethacin farnesil (a prodrug of indomethacin) was effective for myalgia and also decreased the number of CD16(+) CD56(-) NK cells. NK lymphocytosis is rarely associated with autoimmune disease, but the combination of indomethacin and steroid therapy may have a favorable effect for such patients.

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“…Serum levels of TNF- α in healthy control sera have been reported to be lower than 6 pg/mL in a case study of a patient with large granular lymphocyte syndrome (LGL) [ 18 ]. Also, in a study of healthy subjects the mean TNF- α serum levels were reported to be between 30 and 40 pg/mL depending on age [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Serum Markers in Rheumatoid Arthritis: A Longitudinal Study of Patients Undergoing Infliximab Treatment

Selaas

Nordal

Halse

et al. 2015

International Journal of Rheumatology

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Objective. The aim of this study was to investigate the clinical effect and serum markers in a cohort of rheumatoid arthritis patients with moderate to high disease activity, participating in an open clinical phase IV study conducted in Norway between 2001 and 2003 receiving infliximab treatment. Method. A total of 39 patients were studied, with a mean age of 54 years and 12-year disease duration. The analyses were performed using serum from patients at four assessment time points: baseline and 3, 6, and 12 months after starting treatment with infliximab. A wide variety of clinical data was collected and disease activity of 28 joints and Simple Disease Activity Index were calculated. The joint erosion was determined by X-ray imaging and the Sharp/van der Heijde score was determined. Serum analysis included multiplex immunoassays for 12 cytokines, 5 matrix metalloproteases, and 2 VEGFs. Results. The majority of the RA patients in this study had initially moderate to high disease activity and the infliximab treatment reduced the disease activity significantly and also reduced any further joint destruction and improved disease status. Most of the serum levels of cytokines and metalloproteases remained unchanged during the course of the study, and we were unable to detect changes in TNF-α in serum. Serum levels of IL-6 and VEGF-A decreased significantly after initiation of infliximab treatment. Conclusion. The serum levels of IL-6 and VEGF-A may be promising disease markers as they vary with disease progression. The clinical significance of these findings is yet to be determined and has to be confirmed in future clinical trials before being applied in the clinics.

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Elevated serum cytokine levels in a rheumatoid arthritis patient with large granular lymphocyte syndrome

Cited by 11 publications

References 3 publications

Lymphoproliferative disease of granular lymphocytes with T‐cell receptor gamma delta‐positive phenotype: restricted usage of T‐cell receptor gamma and delta subunit genes

Lymphoproliferative disease of granular lymphocytes with T‐cell receptor gamma delta‐positive phenotype: restricted usage of T‐cell receptor gamma and delta subunit genes

Successful Treatment of Primary Sjoegren's Syndrome with Chronic Natural Killer Lymphocytosis by High-Dose Prednisolone and Indomethacin Farnesil

Serum Markers in Rheumatoid Arthritis: A Longitudinal Study of Patients Undergoing Infliximab Treatment

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