Systemic lupus erythematosus and the risk of malignancy

Cibere, Jolanda; Sibley, John; Haga, May

doi:10.1191/096120301678646128

Cited by 159 publications

(152 citation statements)

References 23 publications

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“…There is known to be an increased incidence of non-Hodgkin's lymphoma in autoimmune diseases, including Sjogren's syndrome, rheumatoid arthrits and systemic lupus erythematosis, but again the blastic variant of mantle cell lymphoma has not been reported. [3][4][5] Both of our cases were females less than 60 years old, whereas the majority of cases …”

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confidence: 92%

Reply to Munro et al

Bernard

Lamy

2002

Leukemia

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Correspondence 1889 with cyclin D1. The cells were negative for anti-CD 10, 23, LMP1 and in situ hybridisation for Epstein-Barr virus RNA (EBERs) was also negative. A diagnosis of blastic variant of mantle cell lymphoma was made.CT scanning showed evidence of lymphomatous nodules in the lungs and a 4 cm mass at the bifurcation of the aorta, but there was no disease in the bone marrow. Her LDH was within normal limits.The patient was given one course of chemotherapy with ifosphamide, etoposide and epirubicin (IVE), but developed ifosphamideinduced encephalopathy requiring treatment with methylene blue. Her second course of chemotherapy was with mitozantrone and cytarabine. Following this, a repeat CT scan showed residual thickening of the stomach, but resolution of the lung and para-aortic disease. She received further chemotherapy with carmustine, etoposide, cytarabine and melphalan (mini-BEAM), but failed to mobilise stem cells. She relapsed aggressively 2 months after finishing chemotherapy and died.Immunosuppression has long been associated with an increased risk of lymphoma. This is thought to be due to increased susceptibility to transformation of B cells by latent infections such as EBV and human herpes 8, with defective immunosurveillance by cytotoxic lymphocytes against malignant cells.The majority of non-Hodgkin's lymphomas (both systemic and CNS) occurring in HIV-infected patients are diffuse large B cell lymphomas, although Burkitt's lymphoma and T cell lymphomas are also reported. 2 To our knowledge, the blastic variant of mantle cell lymphoma has not been previously described in the setting of HIV. As is common with HIV-related lymphoma, our first case was positive for LMP1, whereas the second case which was not related to HIV, was negative for LMP1 and EBERs.The second patient was significantly immunosuppressed over a 20-year period for treatment of autoimmune disease. There is known to be an increased incidence of non-Hodgkin's lymphoma in autoimmune diseases, including Sjogren's syndrome, rheumatoid arthrits and systemic lupus erythematosis, but again the blastic variant of mantle cell lymphoma has not been reported. [3][4][5] Both of our cases were females less than 60 years old, whereas the majority of cases

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confidence: 92%

Reply to Munro et al

Bernard

Lamy

2002

Leukemia

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“…Moreover, Bertansky et al found an increase in abnormal cervical cytology in the lupus group vs. controls (P>0.0008). Furthermore, the abnormal cytopathology was accounted for by an excess of HGSIL and cancer (OR = 3.46; P >0.0003) (16,17) .…”

Section: Discussion:-mentioning

confidence: 99%

Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Girbash¹,

Atta²,

Fahmy³

et al. 2016

IJAR

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Objectives: the frequency of cervical squamous intra-epithelial lesions (SIL) in women with systemic lupus erythematosus (SLE), and the association between clinical parameters, use of immunosuppressant agents, human papillomavirus (HPV) infection, colposcopy, and development of SIL in SLE.Methods: A retrospective case control study conducted in 150 women constituted the study group with confirmed diagnosis of SLE. The enrolled patients divided into study group (no.28) with abnormal pap smears and reference group (no.122) with normal pap smears. All patients subjected to clinical evaluation, colposcopy, directed biopsies, and HPV-ISH testing. All participants reassessed every 6 months for 2 years.Results: mean patient age with abnormal pap smears was 44.8(P = 0.74) years with mean SLE disease duration was 9.3±7.1 years. There was past history of cervical lesions where it was positive in 89.3% (P = 0.001). SLE patients with abnormal pap smears showed significant difference regarding nephritis (P = 0.001) and high titers of Anti-double stranded DNA (P = 0.001) and Antiphospholipid antibodies (P = 0.012). SLEDAI, SDI, and immunosuppressant agent usage found significantly different among patients with abnormal pap smears. HPV Infection found significantly important (P = 0.001) when the infection was high-risk HPV, multiple HPV, or persistent HPV infection among patients with abnormal pap smears. On comparison with cytology, colposcopy, HPV-ISH results, the best sensitivity was with the use of HPV-ISH (90%) then with colposcopy (75%). In addition, the best specificity was with the use of colposcopy (99%). The highest positive predictive value was with colposcopy (94%) and the highest negative predictive value was with HPV-ISH assay (98%). Conclusion:Patients with SLE had higher risk for HPV infection and cervical dysplasia than the general population. Thus, gynecological visits at shorter intervals (3-6 months) recommended for those patients. The use of colposcopy is useful tool in areas where the screening of HPV is not available.

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“…Nossos achados nos permitem sugerir que o controle clínico e laboratorial dos pacientes com tireoidite auto-imune deve ser rigoroso pelo risco destes pacientes desenvolverem no curso de sua evolução um carcinoma papilar da tireóide 22 . No futuro deveremos continuar avaliando a relação da tireoidite auto-imune e do carcinoma papilar da tireóide, porém, em uma população selecionada de pacientes com doença auto-imune sistêmica onde o risco de desenvolver neoplasias é maior que na população em geral 23 e onde a presença de tireoidite auto-imune pode chegar a 44,4% dos pacientes 24 .…”

Section: Tabela 3 -Freqüência De Tireoidite Auto-imune Nos Carcinomasunclassified

Concomitância da tireoidite de Hashimoto e o carcinoma diferenciado da tireóide

Roberti

Sobrinho

Denardin

et al. 2006

Rev. Col. Bras. Cir.

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;Odilon Victor Porto Denardin 2 ; Abrão Rapoport-ECBC 3 RESUMO: Objetivo: Avaliar a associação da tireoidite auto-imune e o carcinoma diferenciado da tireóide na Santa Casa de Misericórdia de Goiânia-Goiás. Método: De 1395 tireoidectomias realizadas de 1994 a 2003, foram selecionadas 120 carcinomas diferenciados (27 foliculares e 93 papilíferos). Foram avaliadas as variáveis clínicas (idade e sexo) com apresentação de freqüências e de sumários de medidas-resumo na descrição estatística. Para aferir a associação de tireoidite auto-imune e carcinoma diferenciado da tireóide em função dos achados histopatológicos, utilizou-se tabelas de contingência e análise pelo teste não paramétrico do quiquadrado de Pearson. Em todos os testes estatísticos foi adotado um nível de significância de 5% (p<0,05). Resultados: 11,1% dos carcinomas foliculares e 18,3% dos carcinomas papilíferos estão associados à tireoidite auto-imune. Existe uma relação de freqüências quatro vezes maior da tireoidite auto-imune com o carcinoma diferenciado da tireóide em comparação com outras doenças tireoideanas (16,7% X 3,6%). Conclusão: Tais resultados permitem inferir que a associação entre a tireoidite auto-imune e o carcinoma diferenciado da tireóide é mais que casual, exigindo uma observação clínico-laboratorial cuidadosa nos portadores da doença auto-imune (Rev. Col. Bras. Cir. 2006; 33(6): 345-349 INTRODUÇÃOA incidência do câncer da tireóide mostra grandes diferenças entre os países e populações em regiões endêmicas sendo sua incidência e mortalidade pelo câncer da tireóide, consideradas maiores que em regiões não endêmicas 1 . Os infiltrados linfocitários da tireóide são encontrados em uma grande variedade de doenças: tireoidite de Hashimoto, tireoidite linfocítica, tireotoxicose, bócio nodular e no câncer da tireóide. Os graus de substituição do parênquima tireoidiano por linfócitos variam de infiltrados difusos a pequenas alterações focais, encontradas nos bócio nodulares e carcinomas 2 , sendo que o nome tireoidite de Hashimoto tem persistido na literatura para descrever a "tireoidite auto-imune", termo usado indevidamente nos casos com tireoidite focal ou generalizada, e deve ser empregado exclusivamente para descrever pacientes com bócio, hipotireoidismo que demonstrem altos títulos de anticorpos antitireóide ou presença de citologia e/ou biópsia comprovando a enfermidade.A incidência de tireoidite de Hashimoto em associação com o carcinoma da tireóide permanece controversa, não se encontrando evidências de que o carcinoma tireoidiano seja originado no epitélio proliferado da tireoidite de Hashimoto. As neoplasias com baixo grau de malignidade (carcinoma papilífero e folicular) ocorriam com maior freqüência nos casos de tireoidite de Hashimoto do que nos carcinomas não papilares e anaplásicos, justificada pela incidência mais comum das neoplasias de baixo grau de malignidade comparativamente àquelas de alto grau, e por afetar um grupo mais jovem de pacientes como foi detectado com a tireoidite de Hashimoto. Há evidências que a reação ...

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Systemic lupus erythematosus and the risk of malignancy

Cited by 159 publications

References 23 publications

Reply to Munro et al

Reply to Munro et al

Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Concomitância da tireoidite de Hashimoto e o carcinoma diferenciado da tireóide

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