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泼尼松龙治疗皮肌炎导致单克隆 B 细胞淋巴细胞增多症加重。

Monoclonal B-cell Lymphocytosis Exacerbated by Prednisolone Therapy for Dermatomyositis.

机构信息

Department of Hematology, Asahi General Hospital, Japan.

Research Center for Allergy and Clinical Immunology, Asahi General Hospital, Japan.

出版信息

Intern Med. 2021 Sep 1;60(17):2853-2858. doi: 10.2169/internalmedicine.6956-20. Epub 2021 Mar 22.

DOI:10.2169/internalmedicine.6956-20
PMID:33746170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8479216/
Abstract

Lymphoproliferative diseases have been associated with various autoimmune diseases. We experienced a case of non-chronic lymphocytic leukemia type monoclonal B-cell lymphocytosis (MBL) that was exacerbated by increasing prednisolone for dermatomyositis and then improved by decreasing the dosage. Because MBL is difficult to diagnose, cases like ours may not be rare. These findings will facilitate our understanding of the mechanism underlying lymphoproliferative diseases and autoimmune diseases.

摘要

淋巴增生性疾病与各种自身免疫性疾病有关。我们遇到一例非慢性淋巴细胞白血病型单克隆 B 细胞淋巴增生症（MBL），因皮肌炎增加泼尼松龙而加重，随后减少剂量后改善。由于 MBL 难以诊断，像我们这样的病例可能并不少见。这些发现将有助于我们理解淋巴增生性疾病和自身免疫性疾病的发病机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/375a88a82d8c/1349-7235-60-2853-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/2293c9869c30/1349-7235-60-2853-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/e88b949ed6f7/1349-7235-60-2853-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/375a88a82d8c/1349-7235-60-2853-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/2293c9869c30/1349-7235-60-2853-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/e88b949ed6f7/1349-7235-60-2853-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3c/8479216/375a88a82d8c/1349-7235-60-2853-g003.jpg

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本文引用的文献

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Risk of non-hematologic cancer in individuals with high-count monoclonal B-cell lymphocytosis.高计数单克隆B细胞淋巴细胞增多症患者发生非血液系统癌症的风险。
Leukemia. 2016 Feb;30(2):331-6. doi: 10.1038/leu.2015.235. Epub 2015 Aug 27.
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Monoclonal B-cell lymphocytosis and early-stage chronic lymphocytic leukemia: diagnosis, natural history, and risk stratification.单克隆B细胞淋巴细胞增多症与早期慢性淋巴细胞白血病：诊断、自然病程及风险分层
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Hospital population screening reveals overrepresentation of CD5(-) monoclonal B-cell lymphocytosis and monoclonal gammopathy of undetermined significance of IgM type.
医院人群筛查显示，CD5(-) 单克隆B细胞淋巴细胞增多症和IgM型意义未明的单克隆丙种球蛋白病的比例过高。
Ann Hematol. 2015 Sep;94(9):1559-65. doi: 10.1007/s00277-015-2409-9. Epub 2015 Jun 5.
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Autoimmune manifestations in patients with Waldenström macroglobulinemia.华氏巨球蛋白血症患者的自身免疫表现
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Atypical lymphocytosis, cold agglutinin hemolytic anemia, and monoclonal gammopathy in an HIV patient with marrow involvement by diffuse large B-cell lymphoma.一名HIV患者出现非典型淋巴细胞增多、冷凝集素溶血性贫血及单克隆丙种球蛋白病，骨髓受累于弥漫性大B细胞淋巴瘤。
Blood. 2013 Nov 28;122(23):3711. doi: 10.1182/blood-2013-08-518357.
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Monoclonal B cell lymphocytosis and "in situ" lymphoma.单克隆 B 细胞淋巴增生症和“原位”淋巴瘤。
Semin Cancer Biol. 2014 Feb;24:3-14. doi: 10.1016/j.semcancer.2013.08.003. Epub 2013 Aug 30.
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MYD88 L265P in Waldenström macroglobulinemia, immunoglobulin M monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specific polymerase chain reaction.用常规和定量等位基因特异性聚合酶链反应检测 Waldenström 巨球蛋白血症、免疫球蛋白 M 单克隆丙种球蛋白病和其他 B 细胞淋巴增殖性疾病中的 MYD88 L265P。
Blood. 2013 Mar 14;121(11):2051-8. doi: 10.1182/blood-2012-09-454355. Epub 2013 Jan 15.
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MYD88 L265P somatic mutation in Waldenström's macroglobulinemia.瓦尔登斯特伦巨球蛋白血症中的 MYD88 L265P 体细胞突变。
N Engl J Med. 2012 Aug 30;367(9):826-33. doi: 10.1056/NEJMoa1200710.
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