Cryoglobulinemic vasculitis in primary Sjogren's Syndrome: Clinical presentation, association with lymphoma and comparison with Hepatitis C-related disease

被引：35

作者：

Argyropoulou, O. D. ^{[1
,2
]}

Pezoulas, V ^{[3
]}

Chatzis, L. ^{[1
,2
]}

Critselis, E. ^{[4
,10
]}

Gandolfo, S. ^{[5
]}

Ferro, F. ^{[6
]}

Quartuccio, L. ^{[5
]}

Donati, V ^{[6
]}

Treppo, E. ^{[5
]}

Bassoli, C. R. ^{[7
]}

Venetsanopoulou, A. ^{[1
,2
]}

Zampeli, E. ^{[9
]}

Mavrommati, M. ^{[11
]}

Voulgari, P. V. ^{[12
]}

Exarchos, T. E. ^{[13
]}

Mavragani, C. P. ^{[8
]}

Baldini, C. ^{[7
]}

Skopouli, F. N. ^{[10
]}

Galli, M. ^{[7
]}

Fotiadis, D., I ^{[3
,14
]}

De Vita, S. ^{[5
]}

Moutsopoulos, H. M. ^{[9
,15
]}

Tzioufas, A. G. ^{[1
,2
]}

Goules, A., V ^{[1
,2
]}

机构：

[1] Natl & Kapodistrian Univ Athens, Sch Med, Dept Pathophysiol, Mikras Asias Str 75, Athens 11527, Greece

[2] Univ Athens, Joint Rheumatol Acad Program, Athens, Greece

[3] Univ Ioannina, Unit Med Technol & Intelligent Informat Syst, Ioannina, Greece

[4] Acad Athens, Ctr Syst Biol, Prote Facil, Biomed Res Fdn, Athens, Greece

[5] Univ Udine, Dept Med Area, Rheumatol Clin, Udine, Italy

[6] Univ Pisa, Dept Clin & Expt Med, Rheumatol Unit, Pisa, Italy

[7] Hosp L Sacco, Infect Dis Unit, Dept Clin & Biomed Sci, Milan, Italy

[8] Natl & Kapodistrian Univ Athens, Med Sch, Dept Physiol, Athens, Greece

[9] Inst Autoimmune Syst & Neurol Dis, Athens, Greece

[10] Harokopio Univ Athens, Dept Nutr & Clin Dietet, Athens, Greece

[11] Euroclin Athens, Dept Internal Med & Toimmune Dis, Athens, Greece

[12] Univ Ioannina, Med Sch, Dept Internal Med, Rheumatol Clin, Ioannina, Greece

[13] Ionian Univ, Dept Informat, Corfu, Greece

[14] FORTH, Dept Biomed Res, Inst Mol Biol & Biotechnol, Ioannina, Greece

[15] Athens Acad Athens, Chair Med Sci Immunol, Athens, Greece

来源：

SEMINARS IN ARTHRITIS AND RHEUMATISM | 2020年 / 50卷 / 05期

基金：

欧盟地平线“2020”;

关键词：

Cryoglobulinemia; Vasculitis; Sjogren's syndrome; HCV infection; PRELIMINARY CLASSIFICATION CRITERIA; MIXED CRYOGLOBULINEMIA; VIRUS-INFECTION; PERIPHERAL NEUROPATHY; MORTALITY; INVOLVEMENT; MORBIDITY; EVOLUTION; DIAGNOSIS; CONSENSUS;

D O I：

10.1016/j.semarthrit.2020.07.013

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To describe the clinical spectrum of cryoglobulinemic vasculitis (CV) in primary Sjogren's syndrome (pSS), investigate its relation to lymphoma and identify the differences with hepatitis C virus (HCV) related CV. Methods: From a multicentre study population of consecutive pSS patients, those who had been evaluated for cryoglobulins and fulfilled the 2011 classification criteria for CV were identified retrospectively. pSS-CV patients were matched with pSS patients without cryoglobulins (1:2) and HCV-CV patients (1:1). Clinical, laboratory and outcome features were analyzed. A data driven logistic regression model was applied for pSS-CV patients and their pSS cryoglobulin negative controls to identify independent features associated with lymphoma. Results: 1083 pSS patients were tested for cryoglobulins. 115 (10.6%) had cryoglobulinemia and 71 (6.5%) fulfilled the classification criteria for CV. p5S-CV patients had higher frequency of extraglandular manifestations and lymphoma (OR=9.87, 95% CI: 4.7-20.9) compared to pSS patients without cryoglobulins. Purpura was the commonest vasculitic manifestation (90%), presenting at disease onset in 39% of patients. One third of pSS-CV patients developed B-cell lymphoma within the first 5 years of CV course, with cryoglobulinemia being the strongest independent lymphoma associated feature. Compared to HCV-CV patients, pSS-CV individuals displayed more frequently lymphadenopathy, type II IgMk cryoglobulins and lymphoma (OR = 6.12, 95% CI: 2.7-14.4) and less frequently C4 hypocomplementemia and peripheral neuropathy. Conclusion: pSS-CV has a severe clinical course, overshadowing the typical clinical manifestations of pSS and higher risk for early lymphoma development compared to HCV related CV. Though infrequent, p5S-CV constitutes a distinct severe clinical phenotype of pSS. (C) 2020 The Authors. Published by Elsevier Inc.

引用

页码：846 / 853

页数：8

共 46 条

[1] Common and rare forms of vasculitis associated with Sjogren's syndrome [J].

Argyropoulou, Ourania D. ;

Tzioufas, Athanasios G. .

CURRENT OPINION IN RHEUMATOLOGY, 2020, 32 (01) :21-28

[2] Hepatitis C virus infection of peripheral nerves in type II cryoglobulinaemia [J].

Bonetti, B ;

Scardoni, M ;

Monaco, S ;

Rizzuto, N ;

Scarpa, A .

VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY, 1999, 434 (06) :533-535

[3] Cryoglobulinemia Vasculitis [J].

Cacoub, Patrice ;

Comarmond, Cloe ;

Domont, Fanny ;

Savey, Lea ;

Saadoun, David .

AMERICAN JOURNAL OF MEDICINE, 2015, 128 (09) :950-955

[4]

De Vita S, 2000, ARTHRITIS RHEUM, V43, P94, DOI 10.1002/1529-0131(200001)43:1<94::AID-ANR12>3.0.CO

[5]

2-8

[6] Preliminary classification criteria for the cryoglobulinaemic vasculitis [J].

De Vita, S. ;

Soldano, F. ;

Isola, M. ;

Monti, G. ;

Gabrielli, A. ;

Tzioufas, A. ;

Ferri, C. ;

Ferraccioli, G. F. ;

Quartuccio, L. ;

Corazza, L. ;

De Marchi, G. ;

Casals, M. Ramos ;

Voulgarelis, M. ;

Lenzi, M. ;

Saccardo, F. ;

Fraticelli, P. ;

Mascia, M. T. ;

Sansonno, D. ;

Cacoub, P. ;

Tomsic, M. ;

Tavoni, A. ;

Pietrogrande, M. ;

Zignego, A. L. ;

Scarpato, S. ;

Mazzaro, C. ;

Pioltelli, P. ;

Steinfeld, S. ;

Lamprecht, P. ;

Bombardieri, S. ;

Galli, M. .

ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (07) :1183-1190

[7] Cryoglobulinaemia related to Sjogren's syndrome or HCV infection: differences based on the pattern of bone marrow involvement, lymphoma evolution and laboratory tests after parotidectomy [J].

De Vita, Salvatore ;

Quartuccio, Luca ;

Salvin, Sara ;

Corazza, Laura ;

Zabotti, Alen ;

Fabris, Martina .

RHEUMATOLOGY, 2012, 51 (04) :627-633

[8]

DeVita S, 2019, CRYOGLOBULINEMIA

[9] Research on collaborative negotiation for e-commerce. [J].

Feng, YQ ;

Lei, Y ;

Li, Y ;

Cao, RZ .

2003 INTERNATIONAL CONFERENCE ON MACHINE LEARNING AND CYBERNETICS, VOLS 1-5, PROCEEDINGS, 2003, :2085-2088

[10]

Galli M, 2017, CLIN EXP RHEUMATOL, V35, pS67

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