Risk factors
for malignant lymphoproliferation in Sjögren’s syndrome
Dejmková H.1, Bečvář R.1, Střítecký J.2, Hnátková M.3, Žikešová E.3, Trněný M.3
1Revmatologický ústav, Praha, 2Ústav patologie, Praha, 3I. interní klinika UK, Praha |
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Summary:
Sjögren’s syndrome is a chronic autoimmune disease characterized by lymphoproliferative infiltration of
exocrine glands. Infiltration leads to deterioration of gland and alteration of its function such as loss of
tears and decreased salivary excretion. Course of the disease is characterized by either local autoimmune
process or systemic disease affecting many internal organs. Regarding the fact that Sjögren’s syndrome
is mostly associated with malignant transformation to lymphoproliferative disease, it is considered as
a borderline disease between autoimmunity and malignant lymphoproliferation. The results of several
studies evaluating risk factors for malignant transformation are inconsistent. The enlargement of parotid
gland, lymphadenopathy, palpable purpura, cutaneous vasculitis and neuropathy belong to the most
frequently referred clinical risk factors. Lymphocytopenia, decline in CD4 positive lymphocytes, hypogammaglobulinemia,
monoclonal gammapathy, cryoglobulinemia and low levels of complement C3 and C4
represent the most frequently referred laboratory risk factors. Presented case report describes most of
abovementioned risk factors in a patient who demonstrated transformation from primary Sjögren’s syndrome
to diffuse large B-cell non-Hodgkin lymphoma with kappa positive plasmocellular differentiation.
Key words:
Sjögren’s syndrome, lymphoma, risk factors for malignant transformation
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