J.-M. Durand

Normalization of serum-free light chains in patients with systemic lupus erythematosus upon rituximab treatment and correlation with biological disease activity.

Increased free light chain (FLC) levels have been reported as useful in various autoimmune conditions. We investigated how FLC concentrations change upon B cell targeted therapy in systemic lupus erythematosus (SLE) patients and if they correlate with disease activity. We retrospectively studied 11 SLE patients without renal failure, whom were treated with rituximab. Quantitative determination of IgG, IgA, IgM, and serum FLC was performed before and after rituximab. At baseline, 70% had abnormal serum FLC levels, including increased kappa and lambda levels, while the kappa/lambda ratio was normal for all. A strong correlation was observed between complement C3 fraction and kappa levels (r = −0.929, P < 0.001) or lambda levels (r = −0.854, P = 0.003), but not with IgG, IgA, or IgM levels. After rituximab treatment, kappa and lambda FLC concentrations decreased significantly whilst total concentrations of IgG, IgA, and IgM also decreased but remained within the normal range. There was a strong correlation only between kappa FLC levels and complement C3 fraction consumption (r = −0.543, P = 0.003). In SLE patients without renal failure, increased FLC levels (mainly kappa) with normal kappa/lambda ratios are a common feature, and in contrast to total IgG levels, FLC concentrations correlate with biological disease activity.

Étude de l'association hépatite auto-immune et antiphospholipides

Introduction Only few series have reported the association of autoimmune hepatitis with antiphospholipid antibodies. The aim of our study is to investigate the frequency of these antibodies in a series of autoimmune hepatitis and to search for a correlation with clinical, biological or histological characteristics.

Pulmonary malignancy associated with granulomatous vasculitis in the maxillary sinus

SummaryA 63-year-old man presented with pulmonary infiltrates and maxillary sinusal opacities. Although necrotizing vasculitis and granulomatous inflammation were present in nasal mucosa, pulmonary biopsy revealed adenocarcinoma. Simultaneous appearance of granulomatosis in the maxillary sinus and necrotic lung nodule does not necessarily mean that the lung abnormalities are also granuloma. This case report suggests that differential diagnosis between Wegeners granulomatosis and lung carcinoma may be difficult.