Association between rheumatic diseases and cancer: results from a clinical practice cohort study

Bellan, Mattia; Boggio, Enrico; Sola, Daniele; Gibbin, Antonello; Gualerzi, Alessandro; Favretto, Serena; Guaschino, Giulia; Bonometti, Ramona; Pedrazzoli, Roberta; Pirisi, Mario; Sainaghi, Pier Paolo

doi:10.1007/s11739-017-1626-8

Cited by 28 publications

(30 citation statements)

References 25 publications

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“…Eight of the nine articles identified through the systematic search described cohort stud- (Table I) (15)(16)(17)(18)(19)(20)(21)(22). Two articles utilised the same dataset, but with one considering the outcomes of cancer diagnosis and the other causes of death including cancer (19,20).…”

Section: Articles Included In the Reviewmentioning

confidence: 99%

“…Five of the articles (17)(18)(19)(20)22), all from Scandinavia, used an unexposed group taken from a database separate to the PMR group, but representative of the general population, whilst two studies [one from the UK (15), one from the USA (21)] selected an unexposed group from the same clinical source data as the exposed PMR group (Table I). A final study from Italy selected controls from the same hospital, but with a diagnosis of The real evidence for polymyalgia rheumatica as a paraneoplastic syndrome REVIEW osteoarthritis (16). All studies used a clinical diagnosis of PMR, ascertained from the medical records, whilst six of the studies also used specified criteria for inclusion (15,17,(19)(20)(21)(22).…”

Section: Articles Included In the Reviewmentioning

confidence: 99%

“…Four of the articles explicitly stated that they did not differentiate PMR from giant cell arteritis (GCA) (17)(18)(19)(20), one study included only those patients with PMR symptoms and a negative temporal artery biopsy (22). In the remaining three studies, it was not clear whether those with concomitant GCA were excluded, but all patients were required to have PMR (15,16,21 …”

Section: Articles Included In the Reviewmentioning

confidence: 99%

“…However, limited evidence suggests that haematological and prostate cancers and lymphoma may be the most commonly diagnosed in those with incident PMR (15,16,18) (Table III).…”

Section: Which Cancers Show An Association With Pmr?mentioning

confidence: 99%

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The real evidence for polymyalgia rheumatica as a paraneoplastic syndrome

et al. 2018

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The aim of this study was to systematically consider the evidence for polymyalgia rheumatica (PMR) as a paraneoplastic disease. A systematic review of Medline and Embase was conducted from their inception to February 2017. Risk of bias was assessed using the Newcastle-Ottawa tool. Data were extracted regarding the PMR-cancer association, the types of cancer associated with PMR and the presentation of PMR patients subsequently diagnosed with cancer. Twenty-three full text articles were reviewed from the 1174 unique references identified in the search. Nine articles were included in the final review. There was some evidence of an association between PMR and cancer in the short-term (first 6 to 12 months after diagnosis), but no evidence of an association after this time. Limited evidence suggests that lymphoma, prostate and haematological cancers may be those cancers more commonly diagnosed in those with PMR. There was little evidence to suggest what presenting features may be associated with the development of cancer. There is little evidence of PMR as a true paraneoplastic disease. However, there is reason to be cautious when making the diagnosis of PMR. Clinicians should be aware of this potential association both prior to making a diagnosis and throughout the course of the condition.

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Section: Articles Included In the Reviewmentioning

confidence: 99%

Section: Articles Included In the Reviewmentioning

confidence: 99%

Section: Articles Included In the Reviewmentioning

confidence: 99%

“…However, limited evidence suggests that haematological and prostate cancers and lymphoma may be the most commonly diagnosed in those with incident PMR (15,16,18) (Table III).…”

Section: Which Cancers Show An Association With Pmr?mentioning

confidence: 99%

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The real evidence for polymyalgia rheumatica as a paraneoplastic syndrome

et al. 2018

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“…Rheumatic diseases may be associated to neoplastic conditions. Some rheumatic diseases are associated to an increased risk of developing cancer, for example non-Hodgkin lymphoma in Sjögren's syndrome and rheumatoid arthritis, and some rheumatic diseases or syndromes may be paraneoplastic, such as the classical association between dermatomyositis and cancer [11,12]. A range of autoimmune phenomena may occur related to malignancy.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Granulomatosis with Polyangiitis Associated to Chromophobe Renal Cell Carcinoma: A Case Report

Oliveira¹,

Simaan²,

Neto³

et al. 2017

J Vasc

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Paraneoplastic syndromes are characterized by the set of signs and symptoms of an underlying cancer, frequently occult, due to a variety of remote tumor effects unrelated to the mechanical impact of the tumor mass or distant metastasis [1,2]. Among these syndromes, paraneoplastic vasculitis are very rare, especially necrotizing systemic vasculitis. It is estimated that 2-5% of all causes of vasculitis are paraneoplastic, with the most common presentation being leukocitoclastic cutaneous vasculitis related to hematological malignancies [1,3,4], and fewer cases related to solid organ tumors as an underlying cause.There are some reports of paraneoplastic ANCA-associated vasculitis (AAV), especially granulomatosis with polyangiitis associated with hematological malignancies and with solid organ tumors such as lung and renal carcinomas [5]. We report a case of eosinophilic granulomatosis with polyangiitis (EGPA) associated to chromophobe renal cell carcinoma (chCRR), an unusual form of malignant renal neoplasm, with complete remission of vasculitis after tumor resection.It is important to be aware of the rare association between vasculitis and cancer, since early recognition could provide proper treatment and better prognosis. A 62 year-old man presented with painful palpable purpura on lower limbs and palms, dry cough, dyspnea and fever four weeks prior to admission. He had a long medical history of hypertension and diabetes, and lifetime tobacco exposure of 35 packyears.There was also a severe persistent asthma starting three years before. Weight loss, abdominal pain and urinary symptoms were absent. On physical examination, there were skin lesions (Figure 1), wheezing on chest auscultation and a body mass index of 27.2 kg/m 2 . Laboratory tests showed marked eosinophilia (5,700 cells/mm 3 at admission, peaking 15,520 cells/mm 3 during hospital stay), elevated erythrocyte sedimentation rate (80 mm/h) and C-reactive protein (2,6 mg/dL, NR <0,5 mg/dL). Renal function and urine analysis were normal. Skin biopsy demonstrated eosinophilic leukocitoclastic vasculitis of small vessels with fibrinoid necrosis and eosinophilic perivascular infiltrates (Figure 2). Antinuclear antibody and antineutrophil cytoplasmic antibodies (ANCA) tested negative. Serological tests for hepatitis B and C viruses and acquired human immunodeficiency virus were negative. At admission, chest radiography revealed pulmonary infiltrates.A computerized tomography (CT) scan was performed, showing bilateral alveolar infiltrates and a small indeterminate solid nodule on left lower lobe. Daily oral prednisone was started (up to 1 mg/kg) with no improvement. The patient evolved with respiratory insufficiency, with severe hypoxemia, and then intravenous (IV) methylprednisolone 1 g/day was prescribed for three days. There was a striking improvement, with normalization of eosinophil count and complete resolution of respiratory symptoms. However, the cutaneous vasculitis not only persisted, but also progressed some days after the IV glucocorticoid therapy, ...

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Autoimmune manifestations associated with myelodysplastic syndromes

et al. 2018

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Autoimmune disorders (ADs) are encountered in 10 to 20% of patients with myelodysplastic syndromes (MDS). Available data suggest that ADs concern more often younger patients with higher risk IPSS. MDS subtypes associated with ADs are mainly MDS with single lineage dysplasia (MDS-SLD) and MDS with excess blasts (MDS-EB). Various types of ADs have been described in association with MDS, ranging from limited clinical manifestations to systemic diseases affecting multiple organs. Defined clinical entities as vasculitis, connective tissue diseases, inflammatory arthritis, and neutrophilic diseases are frequently reported; however, unclassified or isolated organ impairment can be seen. In general, ADs do not seem to confer worse survival, although certain ADs may be associated with adverse outcomes (i.e., vasculitis) or progression of MDS (Sweet syndrome). While steroids and immunosuppressive treatment (IST) remain the backbone of first-line treatment, increasing evidence suggests that MDS-specific therapy as hypomethylating agents, based on their immunomodulatory effect, may be effective in treating these complications and for sparing steroids.

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Association between rheumatic diseases and cancer: results from a clinical practice cohort study

Cited by 28 publications

References 25 publications

The real evidence for polymyalgia rheumatica as a paraneoplastic syndrome

The real evidence for polymyalgia rheumatica as a paraneoplastic syndrome

Eosinophilic Granulomatosis with Polyangiitis Associated to Chromophobe Renal Cell Carcinoma: A Case Report

Autoimmune manifestations associated with myelodysplastic syndromes

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