Analysis of Influences of Sjögren's Disease and Anti-Ro/SS-A Antibodies on Clinical Course of Patients with Rheumatoid Arthritis Complicated by Lymphoproliferative Disorders: A Pilot Study.

Background/

Objectives

Lymphoproliferative disorders (LPDs) are adverse effects of methotrexate (MTX) prescribed for rheumatoid arthritis (RA). Sjögren's disease (SjD), for which the presence of anti-Ro/SS-A antibodies (Abs) is a diagnostic criterion, might accompany RA and be a risk factor for LPDs. We conducted a retrospective study to analyze the effects of SjD or anti-Ro/SS-A Ab positivity on the clinical course of patients with RA complicated by LPDs.

Methods

We retrospectively analyzed 25 patients in our department who had RA complicated by LPDs, specifically collecting clinical information regarding the complications of SjD and positivity for anti-Ro/SS-A Abs.

Results

In total, 25 patients with RA were included in this study, 3 of which were diagnosed with SjD by attending physicians based on sicca symptoms and positiveness of anti-Ro/SS-A antibodies. No significant differences in clinical characteristics except for SjD diagnosis given by attending physicians were found between the patients positive for anti-Ro/SS-A Abs and the patients negative for anti-Ro/SS-A Ab. The most common histologic LPD subtype was diffuse large B cell lymphoma, while mucosa-associated lymphoid tissue lymphoma, the histologic subtype often diagnosed as SjD-LPD, was found in only one patient, who was positive for anti-Ro/SS-A Abs without an SjD diagnosis. There were no significant differences in the intervals between the RA and LPD diagnoses and those of SjD and anti-Ro/SS-A Ab positivity.

Conclusions

While the rate of anti-Ro/SS-A Ab positivity in the study population seemed to be higher than that in the general RA population, any potential effects of SjD on RA-LPD development were not ascertained in this study.