Biomedical subjects

B Johansson

Publications and source records attributed to B Johansson.

At least 127 records · Page 7Linked to original sources

PubMed2000

Routine bone scintigraphy is of limited value in the clinical assessment of untreated patients with Hodgkin's disease.

The aim of this retrospective study was to evaluate the role of routinely performed bone scintigraphy in the clinical assessment of patients with previously untreated Hodgkin's disease (HD). One-hundred and eighty-three patients with a median age of 31 yrs (range 16-85) with newly diagnosed HD underwent bone scintigraphy between 1972 and 1995. Bone scintigraphies and skeletal X-ray examinations of patients with any pathological scintigraphic finding were reassessed. Initially HD bone involvement could be excluded in 173 (95%) of the patients. Among the remaining ten patients, two had diffuse increased tracer uptake but X-rays were normal. One of these patients was classified as normal with regard to HD bone involvement. A bone marrow scintigraphy examination and regression of changes following therapy supported primary osseous involvement in the other patient. Five patients had focal scintigraphic abnormalities but skeletal X-rays remained negative; three of these five patients reported pain in the scintigraphically affected areas, and therefore the suspicion of bone involvement was strong. The remaining three patients had focal findings both on bone scintigraphy and skeletal X-ray examination and were considered as having osseous HD involvement. All seven patients judged to have HD bone involvement were planned to receive combination chemotherapy up-front, irrespective of the scintigraphic findings. In this series of 183 patients bone involvement was detected in seven patients based on bone scintigraphy/symptoms (n=3), bone marrow scintigraphy/symptoms (n=1), and bone scintigraphy/X-ray examination (n=3). The decision to give multiagent chemotherapy to all patients was not influenced by scintigraphic findings. Therefore, routine bone scintigraphy seems to be of limited value in the clinical assessment of untreated patients with HD.

Adolescent↗

PubMed2000

Xylulose fermentation by mutant and wild-type strains of Zygosaccharomyces and Saccharomyces cerevisiae.

Anaerobic xylulose fermentation was compared in strains of Zygosaccharomyces and Saccharomyces cerevisiae, mutants and wild-type strains to identify host-strain background and genetic modifications beneficial to xylose fermentation. Overexpression of the gene (XKS1) for the pentose phosphate pathway (PPP) enzyme xylulokinase (XK) increased the ethanol yield by almost 85% and resulted in ethanol yields [0.61 C-mmol (C-mmol consumed xylulose)(-1)] that were close to the theoretical yield [0.67 C-mmol (C-mmol consumed xylulose)(-1)]. Likewise, deletion of gluconate 6-phosphate dehydrogenase (gnd1delta) in the PPP and deletion of trehalose 6-phosphate synthase (tps1delta) together with trehalose 6-phosphate phosphatase (tps2delta) increased the ethanol yield by 30% and 20%, respectively. Strains deleted in the promoter of the phosphoglucose isomerase gene (PGI1) - resulting in reduced enzyme activities - increased the ethanol yield by 15%. Deletion of ribulose 5-phosphate (rpe1delta) in the PPP abolished ethanol formation completely. Among non-transformed and parental strains S. cerevisiae ENY. WA-1A exhibited the highest ethanol yield, 0.47 C-mmol (C-mmol consumed xylulose)(-1). Other non-transformed strains produced mainly arabinitol or xylitol from xylulose under anaerobic conditions. Contrary to previous reports S. cerevisiae T23D and CBS 8066 were not isogenic with respect to pentose metabolism. Whereas, CBS 8066 has been reported to have a high ethanol yield on xylulose, 0.46 C-mmol (C-mmol consumed xylulose)(-1) (Yu et al. 1995), T23D only formed ethanol with a yield of 0.24 C-mmol (C-mmol consumed xylulose)(-1). Strains producing arabinitol did not produce xylitol and vice versa. However, overexpression of XKS1 shifted polyol formation from xylitol to arabinitol.

Anaerobiosis↗

PubMed2000

Antigenic and genetic characterization of the fusion (F) protein of mumps virus strains.

Twelve strains of mumps virus, belonging to the A, C and D genotypes of the small hydrophobic (SH) protein gene, were investigated by nucleotide sequencing of the fusion protein gene. The nucleotide sequences and deduced amino acid sequences were aligned and compared with previously reported sequences of the gene. In addition an antigenic comparison between the F protein of different strains of the A, C and D genotypes was performed with ten monoclonal antibodies directed against the F protein of genotype A. Phylogenetic analysis of the coding region of the F gene showed the expected clustering of the different genotypes, as previously determined from the SH protein gene. Comparison of the 538 long amino acid sequence of the protein showed that only a small number of amino acids differed between the viral strains. The A genotype differed from B, C and D whereas the latter showed fewer consistent amino acid differences between themselves. Nine of the ten monoclonal antibodies reacted with the C and D genotypes and one failed to react with these genotypes. It is concluded that the structure and antigenicity of the F protein is well conserved both intra- and intergenotypically over long periods of time.

Amino Acid Sequence↗

PubMed2000

Reinforcing and neurochemical effects of cocaine: differences among C57, DBA, and 129 mice.

C57BL/6J, DBA/2J, and 129/OlaHsd mice were compared as to their propensity to self-administer cocaine, the ability of cocaine injection to prevent extinction of nose poking in the absence of cocaine infusion, and cocaine's effect on NGFI-A and secretogranin II mRNA. Baseline nose-poke activity tended to be highest in C57 and lowest in DBA mice. C57 and DBA mice self-administered cocaine, as indicated by more frequent nose pokes in mice allowed to infuse cocaine through nose pokes than in mice passively receiving the same amount of cocaine. DBA mice had the larger ratio between active and yoked-control animals, but the response rate in DBA mice was four times lower, and cocaine intake 10 times lower than in C57 mice. The 129 mice showed little response to cocaine. C57 and DBA mice that had been self-administering cocaine showed an extinction of responding when infusions were stopped, preventable by IP cocaine (5 mg kg(-)(1)). A single cocaine injection (2 mg kg(-)(1)) increased NGFI-A mRNA and decreased secretogranin II mRNA in the caudate putamen in C57 mice. These effects were more widespread in DBA and absent in the 129 mice. The marked differences among mouse strains described here will be important to consider when transgenic mice are to be used in cocaine-related studies.

Animals↗

PubMed2000

Alterations of P19ARF in rodent hepatoma cell lines but not in human primary liver cancer.

The tumor suppressor gene CDKN2A is functionally inactivated, through mutations, deletions, or methylation, in a large variety of primary neoplasms as well as tumor cell lines. The CDKN2A locus gives rise to two distinct transcripts. P16INK4 and P19ARF. Because it has been shown that the disruption of only P19arf-coding sequences in mice is sufficient for tumor development, this transcript most likely also encodes a tumor suppressor. We have analyzed the two CDKN2A transcripts in fifteen human primary liver carcinomas, two human hepatoma cell lines, and five rodent hepatoma cell lines. No homozygous deletions of P19ARF and P16INK4 were found in these samples, whereas the normal P19arf transcript was absent in two of the five rodent cell lines (nonexpressed in one case and mutated in another). These results suggest that functional abrogation of P19ARF is not a primary event in hepatocarcinogenesis.

Adult↗

PubMed2000

Fourier analysis of steady-state visual evoked potentials in subjects with normal and defective stereo vision.

The purpose of this work was to study the second harmonic in the steady state pattern visual evoked potential (ssVEP) to various stimulus frequencies in subjects with normal and defective binocularity. ssVEPs were elicited by 4 c/deg sinusoidal gratings, with temporal frequencies ranging from 5 to 20 Hz (exp. 1) and 15 to 27.5 Hz (exp. 2). Responses were Fourier analysed and power and phase of the second harmonic to stimulus frequency were measured. For power, binocular enhancement in a bimodal fashion was found both in normals and in subjects with defective binocularity. The power with binocular stimulation was significantly higher in the normal group in the high frequency domain. Latency, estimated from the phase-frequency function, was longer in the group with defective binocularity, but this was statistically significant only for the high frequency domain. The results suggest that a visual system with normal binocular function can follow a stimulus with high temporal frequency more accurately than a system with disturbed binocularity.

Adolescent↗

PubMed2000

Cytogenetic findings in a population-based series of 787 childhood acute lymphoblastic leukemias from the Nordic countries. The NOPHO Leukemia Cytogenetic Study Group.

Different types of leukemia are characterized by different patterns of nonrandom chromosomal aberrations, but the frequencies with which the various karyotypic subtypes are seen differ among cytogenetic laboratories, countries, and geographic regions. During the 12-yr period 1986-1997, a total of 2054 children (< 15 yr of age) were diagnosed with acute lymphoblastic leukemia (ALL) in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden). Cytogenetic analyses were successfully performed in 1372 patients, 787 (57%) of whom displayed clonal chromosomal abnormalities. ALL with > or = 47 chromosomes was the most frequent cytogenetic subgroup (63%), with massive hyperdiploidy (> or = 52 chromosomes) and chromosome numbers in the tri- and tetraploid range, constituting 46% of all abnormal cases. ALL-associated translocations were found at low frequencies [11q23 translocations in 3.7%, t(9;22)(q34;q11) or del(22q) in 2.2%, t(4; 11)(q21;q23) in 2.0%, t(11;19)(q23;p13) in 1.40%, t(1;19)(q23;p13) in 1.3%, and t(8;14)(q24;q32) in 1%]. Two rearrangements not previously reported in childhood ALL, but recurrent in this population-based material, were identified: der(7;9)(q10;q10) and t(9;12)(q22;p11-12), the molecular genetic consequences of which are unknown. Hyperdiploid childhood leukemias, especially those with a high hyperdiploid modal number, thus seem to be more frequent and ALL-specific translocations less frequent in the Nordic countries than in other geographic regions. Although technical differences among laboratories cannot be ruled out as a cause of at least some of the frequency differences observed compared with previous studies, systematic differences in exposure to environmental oncogenic factors or in geographic/ethnic origin are an intriguing possibility.

Adolescent↗

PubMed2000

Cytogenetic and FISH studies of a single center consecutive series of 152 childhood acute lymphoblastic leukemias.

Between 1977 and 1996, cytogenetic investigations were performed on 182 childhood (< or = 16 yr) acute lymphoblastic leukemias (ALL), constituting 94% (182 of 194) of all ALL patients diagnosed and treated at the Departments of Pediatrics, Lund and Malmo University Hospitals, Sweden, during these two decades. The cytogenetic analyses were successful in 152 cases (84%). The failure rate was higher for the ALL investigated before 1987 (30% vs. 4%, p < 0.0001), and also the incidence of cytogenetically normal cases was higher during 1977-86 (43% vs. 25%, p < 0.05). Clonal chromosomal abnormalities were found in 103 (68%) ALL. Structural rearrangements were detected, by chromosome banding alone, in 76 cases (50%). Fluorescence in situ hybridization (FISH) was used to identify cases with t(12;21), 11q23 rearrangements, and 9p deletions, using probes for ETV6/CBFA2, MLL, and CDKN2A/B, in 72 cases from which cells in fixative and/or unstained metaphase preparations were available. In total, the most common structural rearrangements were del(9p) (17%), t(12;21) (15%), del(6q) (8%), and MLL rearrangements (4%). Six (32%) of nineteen cytogenetically normal ALL analyzed by FISH harbored cryptic abnormalities; three displayed t(12;21) and four had del(9p), one of which also carried a t(12;21). Five (45%) of the t(12;21)-positive ALL showed +der(21)t(12;21) or ider(21)(q10)t(12;21), resulting in the formation of double fusion genes. Among the more rare aberrations, eight structural rearrangements were identified as novel recurrent ALL-associated abnormalities, and nine cases harbored rearrangements previously not reported. Sixteen cases displayed karyotypically unrelated clones at different investigations. Seven ALL (5%) showed simple chromosomal changes, unrelated to the aberrations detected at diagnosis, during morphologic and clinical remission, and in all but one instance the patients remained in remission, with the abnormal clone disappearing in subsequent investigations. This indicates that the emergence of novel clonal chromosomal aberrations during remission in childhood ALL is rather common and does not by necessity predict a forthcoming relapse.

Adolescent↗

PubMed2000

Survival time in a population-based consecutive series of adult acute myeloid leukemia--the prognostic impact of karyotype during the time period 1976-1993.

A consecutive population-based series of 372 adult acute myeloid leukemias, successfully cytogenetically investigated at a single center between 1976 and 1993, is reported. All medical records were reviewed in order to ascertain the prognostic impact of karyotype, divided into three groups; favorable (t(8;21), t(15;17), and inv(16) irrespective of karyotypic complexity; n = 40), poor (der(1;7), inv(3), -5, del(5q), -7, t(9;22), and complex karyotypes including whole or partial losses of chromosomes 5 and/or 7; n = 56), and intermediate (other abnormalities or normal karyotype; n = 276). The possible modification by age, gender, time period, morphologic subtype, and bone marrow transplantation (BMT) on this prognostic impact was also determined. The chemotherapy regimens used were heterogeneous over time but principally the same at any given point in time. The majority of the patients were treated with combinations including an anthracycline and cytarabine with curative intent. Gender, morphology, and BMT did not significantly modify the effect of cytogenetic patterns on survival time, whereas age and time period did. The hazard ratios for the subgroups favorable, intermediate, and poor were 1.0, 1.2 and 1.9 at age 20-49; 1.0, 2.5 and 4.5 at age 50-64; 1.0, 4.1 and 11.4 at age 65-74; 1.0, 1.4 and 2.2 for the time period 1976-1987 and 1.0, 2.0 and 6.7 for 1988-1993. The salient feature of the Kaplan-Meier curves was the improved survival during the later time period for patients with favorable and intermediate cytogenetic abnormalities. The present findings thus suggest that it is mainly these patient groups that have benefited from advances in therapy, including supportive care.

Acute Disease↗

PubMed2000

Prognostic impact of karyotypic findings in childhood acute lymphoblastic leukaemia: a Nordic series comparing two treatment periods. For the Nordic Society of Paediatric Haematology and Oncology (NOPHO) Leukaemia Cytogenetic Study Group.

The prognostic impact of acquired chromosome abnormalities was evaluated in a population-based consecutive series of 768 children (< 15 years of age) with acute lymphoblastic leukaemia (ALL). The study cohort included all cases of cytogenetically abnormal childhood ALL diagnosed between 1986 and 1997 in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). The probability of event-free survival (pEFS) for the total cohort was 0. 72 +/- 0.02. When comparing the two treatment periods of July 1986 to December 1991 and January 1992 to December 1997, a better survival was seen for the latter time period (pEFS of 0.69 +/- 0.02 vs. 0.76 +/- 0.02, P = 0.05). Hypodiploidy with less than 45 chromosomes, t(9;22)(q34;q11) and 11q23 translocations were associated with a dismal outcome during the whole study period (pEFS of 0.57 +/- 0.12, 0.41 +/- 0.14 and 0.37 +/- 0.10 respectively). The poor prognostic influence of 11q23 rearrangements seemed to be restricted to infants and older children (> 10 years), who differed significantly from children aged 1-10 years in this regard (P < 0. 01). Patients with t(9;22)-positive ALL seemed to benefit from allogeneic bone marrow transplantation in first remission (P = 0.05). The pEFS for children with t(1;19)(q23;p13)-positive ALL was intermediate (0.63 +/- 0.17), with a tendency to a better outcome for patients with the unbalanced variant der(19)t(1;19). Hyperdiploid ALL patients, subdivided into moderate hyperdiploidy (47-51 chromosomes), massive hyperdiploidy (52-60 chromosomes) and cases in the tri-/tetraploid range (> 60 chromosomes) had the best outcome in the last treatment period (pEFS of 0.81 +/- 0.06, 0.80 +/- 0.04 and 0.88 +/- 0.07 respectively), unless t(1;19), t(8;14), t(9;22) or 11q23 translocations were present. In a multivariate analysis including white blood cell (WBC) count, immunophenotype, age, mediastinal mass, central nervous system involvement and leukaemia karyotype, only WBC and modal chromosome number were shown to be significant independent risk factors (P < 0.01).

Adolescent↗

PubMed2000

Differences in the effect of chronic and acute caffeine on self-administration of cocaine in mice.

We have compared the ability of an acute injection of caffeine (3 mg/kg, i.p.) and long-term peroral caffeine consumption for 10 days ( approximately 150 mg/kg/day in tap water) to affect cocaine self-administration in mice. The peak plasma and brain levels of caffeine and its metabolites were similar in the two experimental set-ups. Moreover, the levels reached are close to those obtained in humans upon coffee ingestion. Neither type of caffeine administration affected the reinforcing effect of cocaine, defined as a selective increase in nose-poke responses in mice self-administering cocaine compared to their yoked controls. However, caffeine injection increased the amount of cocaine self-administered whereas caffeine drinking reduced it. A low dose of cocaine, by itself essentially ineffective, produced an increase in c-fos and NGFI-A mRNA in the cerebral cortex in mice that had been drinking caffeine. An acute caffeine injection also enhanced the immediate early gene response to cocaine, but to a lesser degree. Cocaine and caffeine also synergistically increased NGFI-A expression in caudate-putamen. Thus, regular caffeine drinking decreased the cocaine intake without significantly affecting its reinforcing properties, perhaps because it enhanced the activation of the predominantly inhibitory frontal cortical areas produced by low doses of cocaine.

Animals↗

PubMed2000

Concentrations of the Pseudomonas aeruginosa toxin pyocyanin in human ear secretions.

Pseudomonas aeruginosa is the most common bacterium in chronic otitis media. Several extracellular factors have been described. Pyocyanin (Pyo) is the blue pigment that gives the bacterium its name "the pyocyanous bacteria". Pyo is known to have an inhibitory effect on the activity of cilia. It is a zwitterion that might easily penetrate biological membranes. Samples of ear secretions for culture and analysis of the concentration of Pyo were collected from 17 patients with different ear infections. Concentrations varied from 3 to 2714 nmol/g, with a mean of 905 nmol/g. For comparison, concentrations were also measured in bacteriological filtrates of P. aeruginosa obtained from wounds and urine specimens. Concentrations in filtrates varied from 13 to 8114 nmol/g, mean 1968 nmol/g. The results indicate that pyocyanin might act as virulence factor that compromises ciliary function and enables the microorganism to establish itself within the ear.

Adolescent↗

PubMed2000

The role of the general practitioner in cancer care and the effect of an extended information routine.

OBJECTIVE: To describe the role of the General Practitioner (GP) in the care of one specified cancer patient per GP, and to explore the GP's knowledge about that patient's disease and treatments, and what information she/he wanted versus received from the specialist clinic. A further aim was to evaluate the effects of an Extended Information Routine (EIR), including increased information from the specialist clinic to the GP. DESIGN: Semi-structured interviews with GPs about a patient randomised between an extended information routine and standard information from the specialist clinics. SETTINGS: Primary Health Care. SUBJECTS: 20 GPs, 10 who received extended information about the specified patient and 10 who did not. MAIN OUTCOME MEASURES: The extent of GPs' contact with the patient, GPs' potential or actual possibilities to support the patient, desired and received information from the specialist clinic. RESULTS AND CONCLUSIONS: GPs are commonly involved in the care of cancer patients, particularly in the diagnostics of the disease but also during the periods of treatment and follow-up. The information from the specialist clinic to the GP is insufficient in standard care. The extended information routine increased the GPs' knowledge of the disease and treatments, and facilitated their possibilities to determine patients' need for support.

Attitude of Health Personnel↗

PubMed2000

Smoking and myelodysplastic syndromes.

The purpose of this case-control study was to investigate tobacco smoking as a risk factor for myelodysplastic syndromes, emphasizing karyotypic aberrations as markers for exposure and risk differentiation with respect to morphology. We obtained smoking history by interview of 330 cytogenetically investigated adult myelodysplastic syndrome cases and 337 controls, matched with respect to sex, year of birth, and county of living. Smoking for at least 1 year at some time 20 years or less before diagnosis was associated with an elevated relative risk (RR) for primary myelodysplastic syndromes (odds ratio (OR) 1.8; 95% confidence interval (CI) = 1.2-2.7). The results indicated a relation with intensity and duration of smoking as well as a decrease in risk a few years after cessation of smoking. Smoking was associated with an increased RR for primary myelodysplastic syndromes with chromosome 7 abnormalities (OR 5.0; 95% CI = 1.1-23). Elevated RRs were also seen for refractory anemia (OR 2.5; 95% CI = 1.2-5.6) and for refractory anemia with ringed sideroblasts (OR 3.2; 95% CI = 0.88-12). The findings suggest that smoking is a risk factor for myelodysplastic syndromes.

Aged↗

PubMed2000

The human cationic antimicrobial protein (hCAP-18) is expressed in the epithelium of human epididymis, is present in seminal plasma at high concentrations, and is attached to spermatozoa.

Innate immunity is important for the integrity of the host against potentially invasive pathogenic microorganisms in the environment. Antibiotic peptides with broad antimicrobial activity are part of the innate immune system. We investigated the presence of the cathelicidin, human cationic antimicrobial protein (hCAP-18), in the male reproductive system. We found strong expression of the hCAP-18 gene by in situ hybridization and hCAP-18 protein, as detected by immunohistochemistry, in the epithelium of the epididymis, but not in the testis. The highest expression in the epididymis was in the caudal part. Western blotting showed a doublet band, the upper part corresponding to the size of hCAP-18 in plasma and neutrophils. Using a specific enzyme-linked immunosorbent assay (ELISA), levels of 86.5 +/- 37.8 microg/ml (mean +/- standard deviation; range, 41.8 to 142.8 microg/ml; n = 10) were detected in seminal plasma from healthy donors, which is 70-fold higher than the level in blood plasma. Flow cytometry and immunocytochemistry revealed the presence of hCAP-18 on spermatozoa. ELISA measurement showed levels of 196 ng/10(6) spermatozoa, corresponding to 6.6 x 10(6) molecules of hCAP-18 per spermatozoon. Our results suggest a key role for hCAP-18 in the antibacterial integrity of the male reproductive system. The attachment of hCAP-18 to spermatozoa may implicate a role for hCAP-18 in conception.

Anti-Bacterial Agents↗

PubMed2000

Increased stroke incidence in Lund-Orup, Sweden, between 1983 to 1985 and 1993 to 1995.

BACKGROUND AND PURPOSE: Some studies suggest that the incidence of stroke may continue to change. We examined recent temporal trends in a defined geographical area of southern Sweden. METHODS: Medical records at the University Hospital of Lund (hospital district population 224 126 in 1993) were retrospectively screened for possible first-ever strokes during 1993 to 1995. Included patients were classified into pathological subtypes (cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and undetermined pathological type) and according to the Oxfordshire Community Stroke Project (OCSP) classification system. Stroke patients from a previous study from 1983 to 1985 in the same area were reevaluated with the same criteria. Epidemiological data for the 2 time periods were compared. RESULTS: There were 998 patients with first-ever stroke in 1983 to 1985 and 1318 in 1993 to 1995. The total incidence rate per 100 000 person-years (age-adjusted to the European population) increased from 134 (95% confidence limits [CL] 126 to 143) to 158 (95% CL 149 to 168). The incidence rate for patients <75 years of age increased from 94 (95% CL 85 to 103) in 1983 to 1985 to 117 (95% CL 108 to 127) in 1993 to 1995, whereas the incidence rate for patients >/=75 years was stable. The age-adjusted incidence rates for the OCSP subtypes lacunar and posterior circulation syndromes increased significantly, by 30% and 55%, respectively. CONCLUSIONS: A marked increase in the incidence of first-ever stroke was observed, surprisingly mainly confined to people <75 years of age. The underlying causes of this increase must be explored in future studies.

Adolescent↗

PubMed2000

Quantitative genetic analysis of biobehavioral markers of aging in Swedish studies of adult twins.

OBJECTIVES: This article will examine the generalizability of markers of aging across samples and cultures and the genetic and environmental influences on them. METHODS: As part of two studies, 18 demographic, cognitive, physiological, personality, and behavioral variables were available from 459 twin pairs ranging in age from 40 to 90 years. Twelve markers of aging were identified using stepwise regression. Factor analysis of the markers produced four factors: general knowledge, fluid abilities, cardiovascular functioning, and well-being. RESULTS: Analysis of twin similarity for the factors suggested that genetic and environmental influences varied greatly. Significant age differences in heritability were found for three of the four factors. DISCUSSION: Results indicate one aging theory cannot account for changes in all markers of aging. Aging of various systems occurs as a result of different combinations of genetic and environmental influences.

Adult↗

PubMed2000

Seropositive polyarthritis and skin manifestations in T-prolymphocytic leukemia/Sezary cell leukemia variant.

Sezary cell leukemia (SCL) is a rare T cell neoplasia that has been suggested to be a variant of T-prolymphocytic leukemia (T-PLL). Both disorders have an aggressive clinical course, lymphocytosis with characteristic morphology, lymphadenopathy, hepatomegaly, characteristic cytogenetic abnormalities and mature T cell phenotypes. Skin lesions, however, are mainly found in T-PLL. We describe a patient with T-PLL/SCL, who atypically presented with severe seropositive polyarthritis and skin lesions, responding to treatment with human CD52 antibody, CAMPATH-1H and pentostatin. Meningeal leukemia and an assumed myocardial infiltration subsequently developed. Polyarthritis is common in T large granular lymphocyte leukemia and adult T cell lymphoma-leukemia, but both entities could be ruled out in the present case. In rheumatoid arthritis, an expansion of CD4+ and/or CD8+ T lymphocytes is well documented and this phenomenon is believed to be of pathogenetic importance. We speculate that the T cell clone in the present case had special homing properties or cytokine effects resulting in synovitis.

Arthritis↗