Case report: Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis

N. G. Klimas, R. Patarca, G. Perez, R. Garcia-Morales, D. Schultz, J. Schabel, M. A. Fletcher

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

To gain insight into the immuno-pathogenesis of drug-induced autoimmune disorders, lymphocyte and immunoglobulin distributions and cytokine levels were monitored in the peripheral blood and pleural fluid of a patient with procainamide-induced lupus and pleural effusion. Approximately 80% of the B cells in both compartments were CD5+ compared to 10% to 25% in normal adults. CD4/CD8 ratio and percentage CD4 were normal in peripheral blood. Serum levels of IgG (particularly IgG2), IL-6, and soluble IL-2R were slightly elevated, and those of IgA were significantly elevated compared to normal controls. Analysis of the pleural effusion revealed an increased CD4/CD8 ratio because of an increased percentage of CD4+CD29+ helper memory T cells, lack of expression of the resting B-cell marker CD21, immune complex deposition and complement consumption, increased relative levels of ANA, abnormally high levels of IL-6 and soluble IL-2R, and detectable levels of IL-1b, IFN-g and TNF-a. These observations provide evidence for the involvement of CD5+ B cells and differential helper T-cell activity in procainamide-induced lupus and for an association between local lymphocyte activation and organ pathology.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume303
Issue number2
StatePublished - Jan 1 1992
Externally publishedYes

Fingerprint

Serositis
Procainamide
CD4-CD8 Ratio
B-Lymphocytes
Pleural Effusion
Helper-Inducer T-Lymphocytes
Interleukin-6
Immunoglobulin G
Lymphocyte Activation
Antigen-Antibody Complex
Immunoglobulin A
Immunoglobulins
Lymphocytes
Pathology
Cytokines
Serum
Pharmaceutical Preparations

Keywords

  • Autoimmunity
  • Cytokines
  • Procainamide

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Klimas, N. G., Patarca, R., Perez, G., Garcia-Morales, R., Schultz, D., Schabel, J., & Fletcher, M. A. (1992). Case report: Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis. American Journal of the Medical Sciences, 303(2), 99-104.

Case report : Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis. / Klimas, N. G.; Patarca, R.; Perez, G.; Garcia-Morales, R.; Schultz, D.; Schabel, J.; Fletcher, M. A.

In: American Journal of the Medical Sciences, Vol. 303, No. 2, 01.01.1992, p. 99-104.

Research output: Contribution to journalArticle

Klimas, NG, Patarca, R, Perez, G, Garcia-Morales, R, Schultz, D, Schabel, J & Fletcher, MA 1992, 'Case report: Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis', American Journal of the Medical Sciences, vol. 303, no. 2, pp. 99-104.
Klimas NG, Patarca R, Perez G, Garcia-Morales R, Schultz D, Schabel J et al. Case report: Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis. American Journal of the Medical Sciences. 1992 Jan 1;303(2):99-104.
Klimas, N. G. ; Patarca, R. ; Perez, G. ; Garcia-Morales, R. ; Schultz, D. ; Schabel, J. ; Fletcher, M. A. / Case report : Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis. In: American Journal of the Medical Sciences. 1992 ; Vol. 303, No. 2. pp. 99-104.
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