Patients with chronic clonal proliferation of large granular lymphocytes (LGL leukemia) often have splenomegaly, neutropenia, and rheumatoid arthritis (RA), thereby resembling the manifestations observed in patients with Felty's syndrome.
The present study sought to determine whether patients with these disorders represent 2 distinct subsets of neutropenic RA.
Prospective cohort study of outpatients attending clinics in university and private hospitals and in offices of private practice physicians.
Twenty-two patients with Felty's syndrome and 22 patients with LGL leukemia, 10 of whom had RA, were studied.
HLA genotyping was performed on peripheral blood mononuclear leukocyte genomic DNA.
Nineteen of the 22 patients with Felty's syndrome (86%) were DR4 positive.
Nine of the 10 patients with LGL leukemia plus RA were also DR4 positive.
In contrast, only 4 of the 12 patients with LGL leukemia without RA (33%) were DR4 positive, a frequency that was within the normal range.
The finding of an equally high prevalence of DR4 in patients with Felty's syndrome and in those with LGL leukemia plus RA suggests that both disorders have a similar immunogenetic basis and are parts of a single disease process rather than 2 separate disorders.
Mots-clés Pascal : Polyarthrite rhumatoïde, Grand lymphocyte granuleux, Etude comparative, Polyarthrite rhumatoïde Felty, Pathogénie, Symptomatologie, Epidémiologie, Etude longitudinale, Système HLA, Génotype, Prévalence, Homme, Chronique, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Rheumatoid arthritis, Large granular lymphocyte, Comparative study, Felty syndrome, Pathogenesis, Symptomatology, Epidemiology, Follow up study, HLA-System, Genotype, Prevalence, Human, Chronic, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0263462
Code Inist : 002B15D. Création : 11/06/1997.