Hypereosinophilia and Seroconversion of Rheumatoid Arthritis
Hypereosinophilia and Seroconversion of Rheumatoid Arthritis
复制标题
类风湿性关节炎的嗜酸性粒细胞增多和血清转化
作者：
R. Rosenstein;R. Panush;N. Kramer;E. Rosenstein
在特应性和自身免疫的交叉点上，我们介绍了一名血清阴性类风湿性关节炎（RA）患者，由于类风湿因子（RF）呈阳性，她出现了嗜酸性粒细胞增多症，但没有其他病因的证据。尽管RA患者嗜酸粒细胞增多的程度被认为反映了RA的严重程度或活动性，但在我们的患者中，嗜酸粒细胞增多是在患者滑膜炎得到良好控制时出现的。尽管嗜酸性粒细胞增多可能反映了相关的药物过敏，但停用用于控制患者疾病的药物阿达木单抗和甲氨蝶呤并不能促进临床改善。也许我们的患者最好奇的方面是在先前血清阴性的 RA 中同时出现类风湿因子血清阳性。外周嗜酸性粒细胞增多和血清转化之间的时间关系表明这些事件之间可能存在联系。我们推测，可诱导嗜酸性粒细胞增多的 T 细胞细胞因子的产生可能同时激活 RF 的产生。
At the intersection of atopy and autoimmunity, we present a patient with seronegative rheumatoid arthritis (RA) who developed hypereosinophilia, without evidence of other etiologies, as she became rheumatoid factor (RF) positive. Although the magnitude of eosinophilia in patients with RA has been thought to reflect the severity or activity of the RA, in our patient, eosinophilia developed at a time when the patient’s synovitis was well controlled. Although eosinophilia may reflect associated drug hypersensitivity, discontinuation of the medications utilized to control our patient’s disease, adalimumab and methotrexate, did not promote clinical improvement. Probably the most curious aspect of our patient was the concomitant development of rheumatoid factor seropositivity in the setting of previously seronegative RA. The temporal relationship between the development of peripheral eosinophilia and seroconversion suggests a possible connection between these events. We speculate that the T cell cytokine production that can induce eosinophilia may simultaneously activate RF production.
影响因子：
15.9
作者：
Paniagua, Ricardo T.;Sharpe, Orr;Robinson, William H.
通讯作者：
Robinson, William H.