Table 3 Clinical and immunological features and lymphoma treatment in patients with SLE and NHL.
| Patient no. | Clinical features of SLE | Laboratorial and immunological features | Clinical presence of lymphoma/Ann Arbor staging at lymphoma diagnosis | Lymphoma treatment | Cause of death |
|---|---|---|---|---|---|
| In parentheses: time interval between first haematological symptom—NHL diagnosis (years) | |||||
| 1 | Arthritis, malar rash, photosensitivity, salivary gland swellings, xerostomia, pulmonary infiltrates, recurrent pneumonias | ANA | B‐symptoms, cervical lymph nodes/IV | Prednimustin | – |
| SS‐A, SS‐B | |||||
| IgG 31 g/l | |||||
| IgM 5.7 g/l | |||||
| 2 | Arthritis, photosensitivity, oral ulcers, pleuritis, leucopenia (4), sicca symptoms | ANA | Nausea, eating problems/IV | Surgery | – |
| SS‐A, SS‐B | 8 CHOP‐M | ||||
| IgG 39 g/l | 5 VePAC | ||||
| IgA 10 g/l | Radiotherapy | ||||
| 3 | Arthritis, pleuritis, pericarditis, pulm infiltrates, leucopenia (13) | ANA | Eye irritation, unilateral exoftalmus/III.1 | Surgery | – |
| DNA | Prednimustin | ||||
| IgG 20 g/l | |||||
| Coombs test + | |||||
| Compl do (C4) | |||||
| 4 | Arthritis, pleuritis, thrombocytopenia (1½), glomerulonephritis | ANA neg | Cervical, axillar lymph nodes, Fever/III.1 | 9 CHVP | Lymphoma |
| SS‐A, SS‐B | |||||
| Compl do (C4) | |||||
| Subnormal IgG | |||||
| 5 | Perimyocardits, pleuritis, leucopenia (10) | ANA | Inch‐sized protuberance in chest wall/II | 4 CHOP | – |
| DNA | Radiotherapy | ||||
| 6 | Arthritis, malar rash, discoid rash, photosensitivity, KCS, leucopenia (15) | ANA | Pathological femur fracture when walking/IV | Radiotherapy | – |
| DNA | Relapse 1 year later: 8 CNOP | ||||
| (False positive) WR | |||||
| IgG 30 g/l | |||||
| 7 | Arthritis, photosensitivity, malar rash, pleuritis, leucopenia, thrombocytopenia, haemolytic anaemia (21) | ANA | Fatigue | Death short after lymphoma diagnosis | Lymphoma |
| “Hypergamma” | Pancytopenia/IV | ||||
| 8 | Arthritis, pleuritis, pulmonary infiltrates, anaemia, leucopenia, severe immunological thrombocytopenia (4) | ANA | Swelling, pain left cheek/II | CHOP | Lymphoma (after second CHOP) |
| Coombs test+ | |||||
| Anticardiolipin antibodies | |||||
| IgG 21 g/l | |||||
| 9 | Arthritis, pleuritis, pleuropneumonia, leucopenia, autoimmune haemolytic anaemia (8) | ANA | Severe abdominal pain/II | Surgery | Info |
| (False positive) WR | Missing | ||||
| Compl do (C4) | |||||
| Coombs test+ | |||||
| IgA 4,9 g/l | |||||
| 10 | Arthritis, recurrent pneumonias, pulmonary infiltrates, leucopenia (9) | ANA | Lymphadenopatia, fever/III | Klorambucil+Prednisolone | Respiratory insufficiency, cor pulmonale |
| IgG 20 g/l | |||||
| Serume M protein | |||||
| 11 | Arthritis, photosensitivity, oral ulcers, recid serositis | ANA | Unilateral pelvis dilatation, B‐symptoms/IV | Vincristine, cerubidin, cyclophosphamide, methotrexate, cytarabine started | Ad mortem 1 month after chemotherapy start; septic shock |
| DNA | |||||
| IgG 16 g/l | |||||
| 12 | Arthritis, sicca symptoms, pleuritis, leucopenia, (4) thrombocytopenia (ITP), pulmonary infiltrates | ANA | B‐symptoms/IV | 8 CHOP + | …Ad mortem in clinical picture of septic chock |
| Sm, RNP | Etoposide start but… | ||||
| SS‐A | |||||
| IgG 40 g/l | |||||
| IgM 7 g/l | |||||
| IgA deficiency | |||||
| 13 | Glomerulonephritis, leucopenia, thrombocytopenia (>16), oral ulcers, pericarditis | ANA | B‐symptoms, lymph nodes/III.2 | 8 CHOP | Ad mortem |
| Candida sepsis | |||||
| 14 | Photosensitivity, pleuropericarditis, KCS, leucopenia (8) | ANA | Impaired nose breathing, swelling/I | Radiotherapy | Info |
| (False positive) WR | Relapse: radiotherapy | Missing | |||
| IgA 4,5 g/l | |||||
| 15 | Arthritis, pleuritis, haemolytic anaemia, leucopenia (16) | ANA | Fever, fatigue/IV | Chlorambucil | Septicaemia (pseudomonas) |
| IgM 24 g/l | |||||
| Compl do (C4) | |||||
| 16 | Arthritis, pericarditis, pleuropneumonia, pulmonary infiltrates, leucopenia (8) | LE‐cells | Fever/IV | – | Lymphoma diagnosis at autopsy |
| IgG 23 g/l |
ANA, antinuclear antibodies; DNA, antibodies to native DNA; SS‐A, antibodies to Ro‐antigens; SS‐B, antibodies to La‐antigens; RNP, antibodies to U1RNP antibodies; Sm, antibodies to Sm antigens; LE‐cells, pos LE cell phenomenon; WR, Wasserman reaction; Compl do (C4), Complement disorder with low C4; Ig, etc, highest measure of an elevated immunoglobulin; KCS, keratoconjunctivitis sicca; CHOP, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone. CHVP, Vinblastine instead of vincristine; VePAC, Etoposide, Prednisolone, Cytarabine, Lomustine.