Sany J, Jorgensen C H, Anaya J M, Didry C, Andary M, Serre I, Baldet P
Service d'Immuno-Rhumatologie, Hôpital Saint-Eloi, Montpellier, France.
Clin Exp Rheumatol. 1993 Jan-Feb;11(1):65-9.
Primary agammaglobulinemia is a rare disorder which is associated with articular symptoms in 11% of patients. Septic arthritis may occur, but often patients complain of chronic oligoarthritis and have a clinical presentation similar to rheumatoid arthritis. We report 2 cases of primary agammaglobulinemia in adults, associated with non-erosive chronic arthritis. Peripheral blood lymphocyte phenotyping showed a predominance of CD8 lymphocytes with a CD4/CD8 ratio < 1. We did not find any abnormalities in cellular immunity. A histological study of the synovium showed chronic synovitis with perivascular CD8 lymphocyte infiltrates. Intravenous infusion of immunoglobulins resulted in a dramatic improvement in the arthritis in both cases. In one patient we noticed a decrease in CD8 lymphocytosis. These results suggest that CD8 lymphocytes are involved in the pathogenesis of the arthritis associated with agammaglobulinemia.
原发性无丙种球蛋白血症是一种罕见疾病,11%的患者伴有关节症状。可发生化脓性关节炎,但患者常主诉慢性少关节炎,临床表现与类风湿关节炎相似。我们报告2例成人原发性无丙种球蛋白血症,伴有非侵蚀性慢性关节炎。外周血淋巴细胞表型分析显示CD8淋巴细胞占优势,CD4/CD8比值<1。我们未发现细胞免疫有任何异常。滑膜组织学研究显示慢性滑膜炎伴血管周围CD8淋巴细胞浸润。静脉输注免疫球蛋白使两例患者的关节炎均显著改善。在一名患者中,我们注意到CD8淋巴细胞增多症有所减轻。这些结果表明,CD8淋巴细胞参与了与无丙种球蛋白血症相关的关节炎的发病机制。