en
Scientific article
English

Felty's syndrome and hypofibrinogenemia: an unusual target for anti-cyclic citrullinated peptide antibodies?

Published inModern rheumatology, vol. 25, no. 5, p. 790-793
Publication date2015
Abstract

Background. Rheumatoid arthritis (RA) is a risk factor for the development of Felty's syndrome and large granular lymphocyte (LGL) leukemia. Anti-cyclic citrullinated peptide (CCP) antibodies are considered highly specific for RA and are directed against various citrullinated antigens, including citrullinated fibrinogen. Anti-CCP antibodies may interfere with the detection of citrullinated proteins and their function. In this article, we describe the possible inhibition of fibrinogen by anti-CCP antibodies with clinical consequences which have never been reported in the literature to our best knowledge. Case report. We present the case of a 79-year-old Caucasian woman with a longstanding history of untreated seropositive RA and who had been investigated for severe neutropenia since several months. The association of splenomegaly led to suspicion of Felty's syndrome. Flux cytometry was compatible with T-cell LGL leukemia. In addition, severe hypofibrinogenemia was detected. The later finding has not been consistently associated with the former clinical entities. Further investigations demonstrated that the anti-CCP antibodies of the patient also recognized the P41 peptide of citrullinated fibrinogen. The patient deceased of intracranial hemorrhage. Conclusion. It is likely, yet not definite, that high anti-citrullinated fibrinogen titers may contribute to low fibrinogen levels and could have contributed to the fatal hemorrhagic event.

Citation (ISO format)
LAZAROU, Ilias et al. Felty’s syndrome and hypofibrinogenemia: an unusual target for anti-cyclic citrullinated peptide antibodies? In: Modern rheumatology, 2015, vol. 25, n° 5, p. 790–793. doi: 10.3109/14397595.2013.844392
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1439-7595
589views
0downloads

Technical informations

Creation07/21/2014 12:29:00 PM
First validation07/21/2014 12:29:00 PM
Update time03/14/2023 9:45:58 PM
Status update03/14/2023 9:45:57 PM
Last indexation01/16/2024 11:51:31 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack