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Antiribosomal-P protein antibodies in a patient with systemic lupus erythematosus and non-Hodgkin’s lymphoma: more than coincidental finding?

Institute of Haematology, Clinical Centre of Serbia, Belgrade, Serbia pedra{at}beotel.yu

B Bonaci-Nikolic

Institute of Allergy and Clinical Immunology, Clinical Centre of Serbia, Belgrade, Serbia

N Colovic

Institute of Haematology, Clinical Centre of Serbia, Belgrade, Serbia

T Terzic

Institute of Haematology, Clinical Centre of Serbia, Belgrade, Serbia

M Colovic

Institute of Haematology, Clinical Centre of Serbia, Belgrade, Serbia

Patients with systemic lupus erythematosus (SLE) are at an increased risk of lymphomas, but mechanisms underlying this association are obscure. Recently, it has been shown that antiribosomal-P protein (anti-P) antibodies cross-react with phospholipids and enhance the production of cytokines which may influence lymphomagenesis. We report a 46-year-old woman who suffered high grade diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL) 28 months after the diagnosis of SLE. Development of lymphoma was associated with occurrence of serum monoclonal IgM, and pronounced prolongation of phospholipid-dependent clotting tests. Anti-P IgG antibodies were highly positive both on HEp-2 cells and in ELISA test. Anticardiolipin, anti-β2 glycoprotein I, and antiprothrombin IgM antibodies have also been found in high concentrations. Complete remission of DLBCL and SLE, with normalisation of clotting tests, and disappearance of M component was achieved with administration of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. The progression of SLE to DLBCL associated with presence of anti-P antibodies has not been previously reported. This association may not be coincidental, but further investigations are required to confirm this hypothesis.

Key Words: antiribosomal-P protein antibodies • non-Hodgkin’s lymphoma • rituximab • systemic lupus erythematosus

Lupus, Vol. 18, No. 1, 81-85 (2009)
DOI: 10.1177/0961203308093549


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