期刊
JCR-JOURNAL OF CLINICAL RHEUMATOLOGY
卷 16, 期 6, 页码 280-283出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RHU.0b013e3181eeb761
关键词
splenectomy; autoimmunity; systemic lupus erythematosus; immune-mediated thrombocytopenia; rheumatoid arthritis; autoimmune hepatitis; memory B cells; CD95
类别
In years past, there was concern that splenectomy could lead to dissemination of occult systemic lupus erythematosus. Clinical studies subsequently effectively refuted that concept. However, there remains uncertainty regarding the role of the spleen in autoimmune diseases and the effect of splenectomy on their course. We present a case of a 56-year-old woman with autoimmune hepatitis and rheumatoid arthritis, without clinical or serologic features of lupus, who developed glomerulonephritis and antiphos-pholipid syndrome subsequent to an elective splenectomy. Literature review was performed to identify examples of the effect of splenectomy on other autoimmune diseases. Splenectomy has been linked with the development of new autoimmune phenomenon, alterations in the clinical course of patients with prior autoimmune disease, such as in our patient, and in a progressive redistribution of memory B cells that may influence autoimmune disease activity and may have been involved in the alteration in our patient's clinical course.
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