Hodgkin´s Lymphoma and Autoimmunity: Is There a Relationship?

Introduction: The relationship between lymphomas and autoimmune diseases has been reported as bi-directional, however there is a few data in pediatric population. The aim of this work is to evaluate the prevalence of autoimmune diseases in children and adolescents with Hodgkin´s lymphoma followed in a Pediatric Oncology Unit. Material and Methods: By reviewing Hodgkin’s lymphomas data from the past 16 years (collected prospectively), an apparently large incidence of autoimmune diseases, mostly in female patients, was noted. We decided to do this retrospective study with an update on follow-up. Data analyzed: age, gender, autoimmune disease, temporal relation with lymphoma, lymphoma´s stage, histologic subtype and treatment. Results: Fifty-two cases were included, 7 (13.5%) of which, all female, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. Autoimmune diseases were: juvenile idiopathic arthritis, inflammatory bowel disease, Behçet´s disease, autoimmune hepatitis, systemic erythematosus lupus, Hashimoto´s thyroiditis and idiopathic thrombocytopenic purpura. The diagnosis was made after lymphoma in 4 patients, before in 2 and simultaneously in 1 patient. All cases, except the one with simultaneous diagnosis, are out of treatment and without oncologic disease relapse. No deaths were registered. Discussion: There was an important prevalence of autoimmune diseases in girls with Hodgkin´s lymphoma. We present data and discuss the possible causes based on a literature review. Conclusions: This relationship should be invoked, requiring more studies, especially in pediatric age.

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Predictive autoimmunity using autoantibodies: screening for anti-nuclear antibodies

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2017-0241 ◽

2018 ◽

Vol 56 (10) ◽

pp. 1771-1777 ◽

Cited By ~ 17

Author(s):

Dolores Pérez ◽

Boris Gilburd ◽

Óscar Cabrera-Marante ◽

Jose A. Martínez-Flores ◽

Manuel Serrano ◽

...

Keyword(s):

Autoimmune Disease ◽

Early Detection ◽

Autoimmune Diseases ◽

Antinuclear Antibodies ◽

Standard Technique ◽

Clinical Suspicion ◽

Follow Up Study ◽

Asymptomatic Subjects

Abstract Background: Early detection of antinuclear antibodies (ANA) in asymptomatic subjects is useful to predict autoimmune diseases years before diagnosis. ANA have been determined by indirect immunofluorescence (IIF) using human epithelial type 2 (HEp-2) cells, which is considered the gold standard technique. Multiplex technology (BioPlex ANA Screen) has been introduced for ANA evaluation in recent years. Nevertheless, concordance between BioPlex and IIF is low and there is no harmonization between both methods for detection of autoantibodies. This study has aimed to clarify the clinical significance of autoantibodies detected by BioPlex ANA Screen in subjects with undiagnosed clinical suspicion of autoimmune disease and to determine the predictive value of autoantibodies detected by BioPlex ANA Screen. Methods: A 3-year follow-up study was performed of 411 subjects without a clear diagnosis of autoimmune diseases in whom autoantibodies were detected by BioPlex ANA Screen that were negative by IIF on HEp-2 cells. Results: At 3 years of follow-up, 312 (76%) subjects were positive for autoantibodies by IIF and 99 subjects continued to be negative. A diagnosis of autoimmune disease was found in most of the subjects (87%). Conclusions: BioPlex ANA Screen has greater sensitivity than IIF on HEp-2 cells for autoantibodies detection. Early detection of these antibodies by BioPlex can predict possible development of autoimmune diseases.

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Evaluation of adult celiac disease from a tertiary reference center: a retrospective analysis

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.1.55 ◽

2020 ◽

Vol 66 (1) ◽

pp. 55-60

Author(s):

Omer Burcak Binicier ◽

Ferahnaz Tosun

Keyword(s):

Celiac Disease ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Gastrointestinal Symptoms ◽

Single Type ◽

Adult Celiac Disease ◽

Antibody Positivity ◽

The Mean ◽

Time Of Admission

SUMMARY OBJECTIVE It has been observed that celiac disease (CD) is not restricted to a single type characterized by diarrhea but also has atypical, asymptomatic (silent), and latent forms. The prevalence of this autoimmune disease, which affects approximately 1% of the world, is estimated to be around 3%, including atypical and asymptomatic cases. In our study, we aimed to evaluate adult celiac patients. METHODS Between December 2008-2015, patients diagnosed with CD over the age of 18 years old were included in the study. Patients’ symptoms at admission, frequency and type of anemia, transaminase levels, and celiac antibody positivity, and autoimmune diseases diagnosed at follow up were evaluated retrospectively. RESULTS Of 195 patients, 151 (77.4%) were female. The mean age of the patients was 35.73 ± 12.19 years (range, 18-71 years). A hundred patients (51.3%) had gastrointestinal symptoms. At the time of admission, 118 patients (60.5%) had anemia, and 52 (26.7%) had hypertransaminasemia. During the mean follow-up period of 58 months (36-120 months), 84 (43.1%) of the patients presented at least one autoimmune disease, and this rate was 96.6% in individuals diagnosed above the age of 50 years. CONCLUSION In adult CD, resistant anemia, dyspepsia, and hypertransaminasemia are very common findings at the time of diagnosis, and the association with other autoimmune diseases, especially Hashimoto’s thyroiditis, is high.

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Lack of Clinical Relevance of ANA and ASMA Positivity in Patients with Liver Transplantation without a History of Autoimmune Diseases

BioMed Research International ◽

10.1155/2017/2456916 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Lucienne Pellegrini ◽

Gianpaolo Parrilli ◽

Antonella Santonicola ◽

Luigi Cinquanta ◽

Cesare Caputo ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Autoimmune Disease ◽

Liver Injury ◽

Autoimmune Diseases ◽

Clinical Relevance ◽

Serum Antibody ◽

History Of ◽

One Year ◽

The One

The relevance of isolated autoimmunity elevation in orthotopic liver transplantation (OLT) patients is unknown. Our aim was to analyse how serum autoantibodies change in time and to evaluate their clinical relevance in OLT patients. Patients were invited to provide samples to evaluate ANA, AMA, ASMA, and LKM at the time of enrolment (T0), after 6 months (T6), and after 12 months (T12). We included 114 patients in the study (76% males, median age 62.5 years), finding isolated elevation of at least one serum antibody in up to 80% of them. We described fluctuating positive autoantibodies in the one year of observation, with only 45.6% of patients positive for ANA and less than 2% positive for ASMA, at all three times. Isolated elevation of tissue antibodies was not related to gender, age, HCC at transplant, early rejection, cause of transplantation, immunotherapy taken, and age at the time of the study. We did not detect a higher prevalence of positive autoimmunity in patients with signs of liver injury. ANA and ASMA evaluation in patients with liver transplantation and no history of autoimmune disease has no clinical relevance, since it varies in time and is not related to any risk factors or liver injury. Routine autoimmunity evaluation should be avoided.

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Autoantibodies persist in relatives to systemic lupus erythematosus patients during 12 years follow-up

Lupus ◽

10.1177/0961203316676378 ◽

2016 ◽

Vol 26 (7) ◽

pp. 723-728 ◽

Cited By ~ 1

Author(s):

H Langkilde ◽

A Voss ◽

N Heegaard ◽

H Laustrup

Keyword(s):

Systemic Lupus Erythematosus ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Population Based ◽

Systemic Lupus ◽

Autoantibody Production ◽

Increased Risk ◽

Reported Health

Background Systemic lupus erythematosus (SLE) is an autoimmune disease with presence of autoantibodies and characteristic multi-organ involvement. Relatives of SLE patients have an increased risk of autoantibody production and autoimmune diseases. Methods In 2001, 226 first degree relatives (FDRs) of a population-based cohort of SLE patients were examined for the prevalence of autoantibodies and self-reported health complaints. In 2013, 143 FDRs were re-investigated and deceased’s medical records were examined. Results Participants and non-participants were comparable regarding baseline characteristics, while deceased FDRs were older than participants, but with comparable ANA status. ANA status at baseline correlated to ANA status at follow-up. At follow-up, two FDRs reported SLE and 15 FDRs other autoimmune diseases. No observation at baseline alone could predict self-reported health. During follow-up 33 died at median age 76 years. Three deceased FDRs were diagnosed with an autoimmune disease. Conclusion The study showed that FDRs of SLE patients have an increased prevalence of ANA compared to healthy controls. The prevalence increased during follow-up, and ANA positive FDRs at baseline were prone to be ANA positive at follow-up. ANA positive FDRs had more self-reported autoimmune diseases, including SLE and rheumatoid arthritis, than reported from other population-based investigations.

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AB1051 KIKUCHI FUJIMOTO DISEASE, IS IT SLE?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5460 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1815.3-1816

Author(s):

J. Camins-Fàbregas ◽

V. Ortiz-Santamaria ◽

N. Busquets-Pérez ◽

A. Cuervo ◽

I. Cañas Alcántara ◽

...

Keyword(s):

Autoimmune Disease ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Clinical Manifestations ◽

Response To Treatment ◽

Systemic Autoimmune Disease ◽

Histiocytic Necrotizing Lymphadenitis ◽

Systemic Autoimmune Diseases ◽

Necrotizing Lymphadenitis

Background:Kikuchi-Fujimoto disease (KFD) is a rare entity characterized by adenopathies and fever. It raises a broad differential diagnosis that includes lymphoproliferative disorders, infections and systemic autoimmune diseases, and diagnostic confirmation is always by histology, which shows histiocytic necrotizing lymphadenitis. Although its course is generally benign and self-limited, it can be associated both at the time of diagnosis and during follow-up with systemic autoimmune diseases, the most frequent of which is systemic lupus erythematosus (SLE).Objectives:To describre the clinical and analytical characteristics of patients diagnosed with KFD and the development of systemic autoimmune disease.Methods:Patients diagnosed with KFD during the 1990s and 2020s are collected in a regional hospital (Granollers General Hospital). The clinic is documented at the diagnosis of EKF, the appearance of systemic autoimmune disease during follow-up and its clinical and analytical characteristics.Results:A total of 7 patients with EKF were diagnosed. All of them women with a mean age at diagnosis of 30 years. Diagnosis was made in all cases with compatible clinical symptoms, fever and lymphadenopathy, and lymph node biopsy confirming histiocytic necrotizing lymphadenitis. At the time of diagnosis, a patient was also diagnosed with SLE. During the follow-up, 4 of the 6 remaining patients developed clinical manifestations compatible with SLE (3 of them with systemic manifestations and a case of subacute cutaneous lupus. The mean time of onset of SLE was 34 months (between 6 months and 5 years). All of them received treatment with hydroxychloroquine, with good response to treatment.The clinical and analytical characteristics are presented in Table 1 below.Conclusion:In our center, 5 of the 7 patients (71%) diagnosed with EKF developed manifestations compatible with SLE. The importance of the diagnosis of EKF lies precisely in the possible association with systemic autoimmune disease, the most common being SLE, so it is recommended that patients be monitored to identify those who develop associated autoimmune disease.Disclosure of Interests:None declared

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Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party

Blood ◽

10.1182/blood-2011-02-336156 ◽

2011 ◽

Vol 118 (6) ◽

pp. 1693-1698 ◽

Cited By ~ 87

Author(s):

Thomas Daikeler ◽

Myriam Labopin ◽

Massimo Di Gioia ◽

Mario Abinun ◽

Tobias Alexander ◽

...

Keyword(s):

Risk Factors ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Antiphospholipid Syndrome ◽

Lupus Erythematosus ◽

Working Party ◽

Thyroid Stimulating Hormone ◽

European Multicenter Study ◽

Autologous Hsct

Abstract To specify the incidence and risk factors for secondary autoimmune diseases (ADs) after HSCT for a primary AD, we retrospectively analyzed AD patients treated by HSCT reported to EBMT from 1995 to 2009 with at least 1 secondary AD (cases) and those without (controls). After autologous HSCT, 29 of 347 patients developed at least 1 secondary AD within 21.9 (0.6-49) months and after allogeneic HSCT, 3 of 16 patients. The observed secondary ADs included: autoimmune hemolytic anemia (n = 3), acquired hemophilia (n = 3), autoimmune thrombocytopenia (n = 3), antiphospholipid syndrome (n = 2), thyroiditis (n = 12), blocking thyroid-stimulating hormone receptor antibody (n = 1), Graves disease (n = 2), myasthenia gravis (n = 1), rheumatoid arthritis (n = 2), sarcoidosis (n = 2), vasculitis (n = 1), psoriasis (n = 1), and psoriatic arthritis (n = 1). After autologous HSCT for primary AD, the cumulative incidence of secondary AD was 9.8% ± 2% at 5 years. Lupus erythematosus as primary AD, and antithymocyte globulin use plus CD34+ graft selection were important risk factors for secondary AD by multivariate analysis. With a median follow-up of 6.2 (0.54-11) years after autologous HSCT, 26 of 29 patients with secondary AD were alive, 2 died during their secondary AD (antiphospholipid syndrome, hemophilia), and 1 death was HSCT-related. This European multicenter study underlines the need for careful management and follow-up for secondary AD after HSCT.

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Surgical Treatment is Effective in Treating Thymoma Accompanied with Non-Myasthenia Gravis Autoimmune Diseases: A Single-Center Clinical Experience

Scandinavian Journal of Surgery ◽

10.1177/1457496920964337 ◽

2020 ◽

pp. 145749692096433

Author(s):

L. Liu ◽

J. Zhang ◽

G. Wang ◽

C. Guo ◽

Y. Chen ◽

...

Keyword(s):

Surgical Treatment ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Myasthenia Gravis ◽

Complete Recovery ◽

Treatment Method ◽

Disease Symptoms ◽

Organ Specific ◽

The Mean

Background and Aims: Although thymoma is inextricably linked to autoimmune disease, its best treatment method remains unclear. In this study, we sought to evaluate therapeutic effect of surgical resection of thymoma on non-myasthenia gravis autoimmune diseases. Materials and Methods: This was a retrospective study covering 32 patients with thymoma accompanied with non-myasthenia gravis autoimmune disease. The relationships between surgical treatment, thymoma pathological type, and prognosis of autoimmune diseases were analyzed from postoperative follow-up data. Results: In total, 32 patients in this study underwent surgical treatment. The mean age of the patients was 51.7 years. By the last follow-up, 2 patients had died, while the other 30 patients showed no sign of tumor recurrence and metastasis. According to the postoperative follow-up data, 22 patients (68.75%) showed improvement or even complete recovery of autoimmune disease symptoms, 9 patients (28.13%) showed no significant change, and only 1 patient’s (3.12%) postoperative symptom was aggravated. Female patients and patients aged 50 and older were more likely to combine with non-organ-specific autoimmune diseases (p = 0.036, p = 0.017). Conclusion: In conclusion, this study presents that surgical treatment achieves a satisfactory prognosis for thymoma combined with non-myasthenia gravis autoimmune disease.

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Nonspecific bowel activity in imaging inflammation with Tc-99m labelled monoclonal anti-NCA-90 Fab’ fragment MN3

Nuklearmedizin ◽

10.1055/s-0038-1623873 ◽

2001 ◽

Vol 40 (03) ◽

pp. 71-74 ◽

Cited By ~ 3

Author(s):

A. Wolter ◽

D. L. Munz ◽

V. Ivančević

Keyword(s):

Fab Fragment ◽

Musculoskeletal Infection ◽

Planar Images ◽

Early Imaging ◽

Inflammatory Bowel ◽

The Mean ◽

The One ◽

Bowel Segments ◽

Age Range

Summary Aim: Since the Tc-99m labelled monoclonal anti-NCA 90 granulocyte antibody Fab’ fragment MN3 (MN3 Fab’) might be of interest for imaging abdominal inflammation which could be hampered by nonspecific bowel activity, we prospectively investigated the appearance of bowel activity in MN3 Fab’ imaging. Methods: Eighty consecutive patients (age range 12-85 years) referred for suspected nonabdominal, mostly musculoskeletal infection, were included. Abdominal inflammation was excluded clinically and there were no signs of inflammatory bowel disease in the patients’ histories. One, 5, and 24 hours after intravenous injection of up to 1.1 GBq of MN3 Fab’ planar images of the abdomen were performed. Bowel activity was graded visually using a 5-point scale. Results: The one (N = 80), 5 (N = 79), and 24 (N = 52) hour images revealed 46 (10%), 162 (34%), and 173 (55%) accumulating bowel segments, respectively, in 37 (46%), 69 (87%), and 52 (100%) patients. The mean intensity score per accumulating segment was 1.1,1.8 and 2.7 (p = 0), respectively. Relative frequencies of appearance of the small intestine were 38%, 57%, and 21%, ileocaecal region 6%, 53%, and 48%, ascending colon 5%, 67%, and 89%, transverse colon 1%, 9%, and 69%, descending colon 8%,15 %, and 67%, and rectosigmoid 0%, 4%, and 38%, respectively. Follow-up investigations in 13 patients revealed diverging uptake patterns. Conclusion: Nonspecific bowel activity is often present in the early and almost always and more intense, in the delayed images. Early imaging at one hour after administration seems feasible, but a loss in sensitivity has to be considered. Thus, nonspecific bowel activity can be anticipated to be a pitfall in imaging abdominal inflammation with MN3 Fab’.

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Screening for Autoimmune Markers Is Unnecessary during Follow-up of Adults with Autoimmune Thrombocytopenic Purpura and no Autoimmune Markers at Onset

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613754 ◽

2000 ◽

Vol 83 (01) ◽

pp. 42-45 ◽

Cited By ~ 13

Author(s):

J. M. Vantelon ◽

B. Godeau ◽

C. André ◽

P. Bierling

Keyword(s):

Systemic Lupus Erythematosus ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Antinuclear Antibodies ◽

Autoimmune Disorders ◽

Systemic Lupus ◽

Thrombocytopenic Purpura ◽

Autoimmune Thrombocytopenic Purpura

SummaryIn an attempt to evaluate the frequency of autoimmune markers in autoimmune thrombocytopenic purpura (AITP) and to determine if autoimmune markers in patients with isolated AITP were associated with particular disease manifestations, we analyzed records of 122 consecutive adults with AITP. Twenty-nine patients (24%) had significant titers of one or several autoimmune markers at AITP onset. Among them, 16 (13%) had antinuclear antibodies. The presence of autoimmune markers did not correlate with presenting feature, response to treatment or long-term outcome of AITP. Six patients (5%) developed seven autoimmune diseases during follow-up, comprising systemic lupus erythematosus, an antiphospholipid syndrome, autoimmune haemolytic anemia (n = 2), Grave’s disease, Hashimoto’s disease and primary biliary cirrhosis. At AITP onset, three of these patients had isolated biological markers of the autoimmune disease they later developed. The annual average incidence rate of autoimmune diseases was 1% per patient-year in the entire group and 0.4% in the group of patients with no autoimmune markers at AITP onset. This low rate is probably due to careful assessment at diagnosis for concomitant overt autoimmune disease. We recommend extensive screening for autoimmune markers at AITP onset, and careful follow-up of patients with autoimmune markers. Routine screening for autoimmune markers during AITP follow-up is not necessary for patients with no autoimmune markers at AITP onset.Systemic lupus erythematosus (SLE) and other autoimmune disorders can complicate autoimmune thrombocytopenic purpura (AITP) or be diagnosed concomitantly with otherwise unremarkable AITP (1, 2). However, the frequency and prognostic value of isolated autoimmune markers (i. e. not associated with an autoimmune disorder), particularly antinuclear antibodies (ANA) at AITP onset or during follow-up is controversial (3-8). For example, the committee organized by George et al. (9) to write guideline on the diagnosis and treatment of AITP stated that the search for ANA and lupus anticoagulant were of “uncertain appropriateness at diagnosis and during follow-up”. In an attempt to help practicians to make decisions, we analyzed the frequency of autoimmune markers and autoimmune disorders at onset and during the follow-up in 122 adults with AITP and no overt autoimmune disease at diagnosis. These consecutive patients were followed by the same physician for a mean period of 6 years, and had routine screening tests for autoimmune markers and disorders at onset, before steroid therapy, and regularly during follow-up.

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Association of Hidradenitis Suppurativa (HS) with Autoimmune Disease and Autoantibodies

Rheumatology Advances in Practice ◽

10.1093/rap/rkab108 ◽

2021 ◽

Author(s):

Yael Ross ◽

Stanley Ballou

Keyword(s):

Autoimmune Disease ◽

Autoimmune Diseases ◽

Hidradenitis Suppurativa ◽

Normal Population ◽

Treatment Modalities ◽

Demographic Differences ◽

Biologic Treatment ◽

Icd 10 ◽

Search Tool ◽

Inflammatory Bowel

Abstract Objective There is thought to be an association between Hidradenitis Suppurativa (HS) and autoimmune diseases. This retrospective longitudinal cohort study looked to identify whether certain autoimmune diseases or autoantibody specificities are more closely associated with HS than others and, whether such associations are related to severity of HS. Methods Patients were identified using the SlicerDicer search tool in Epic from January 1, 2010 through August 15, 2020. Search criteria included HS diagnosis by ICD-10 code and at least one visit in dermatology. Charts were reviewed to determine HS disease severity, treatment modalities, presence of autoimmune disease, and autoantibody positivity. Results 627 patients were identified. Most patients were females (75.3%) and had obese BMIs (71.1%), but there were no significant demographic differences between HS patients with and without autoimmune diseases. 101 (16.1%) patients in the total cohort had at least one autoimmune disease, most commonly, thyroid disease, lupus, psoriasis, and inflammatory bowel disease (IBD). 212 patients were also tested for the presence of autoantibodies. The most common positive autoantibody, found in 54 patients (28.4%), was antinuclear antibody (ANA). 54 patients with more severe HS disease manifestations required biologic medications to treat their HS. Neither HS severity nor biologic treatment was associated with presence of autoimmune disease or positive autoantibodies. Conclusion In a large cohort of patients with HS followed longitudinally, autoimmune disorders (especially lupus, psoriasis and IBD) and presence of autoantibodies were more commonly observed than expected in the normal population.

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