Large granular lymphocyte expansions in patients with Felty's syndrome: analysis using anti-T cell receptor V beta-specific monoclonal antibodies

Clin Exp Immunol. 1995 Jul;101(1):18-24. doi: 10.1111/j.1365-2249.1995.tb02271.x.

Abstract

Felty's syndrome (FS), the association of rheumatoid arthritis (RA) and idiopathic neutropenia, remains an unexplained phenomenon. HLA-DR4 is found in over 90% of cases. Patients with FS may have a T cell lymphocytosis of CD3+CD8+CD57+ large granular lymphocytes (LGL syndrome). In this study of 47 patients with FS, 19% had clear evidence for LGL expansions, while in total 42% had variable evidence for the LGL syndrome using currently available techniques. Of these T cell expansions, 76% were clonal, as demonstrated by Southern blotting and analysis with T cell receptor (TCR) beta chain constant region probes. This technique may fail to detect clonal populations in some patients. Cytofluorographic analysis using antibodies specific for TCR V beta chains identified patients with clonal LGL expansions with results comparable to those obtained with Southern blotting. No evidence for shared V beta usage among expansions from different patients was seen. The role of LGL in RA and FS is currently unclear, but this technique offers a practical and accessible means of identifying patients with LGL expansions, as a starting point for further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / immunology
  • Felty Syndrome / immunology*
  • Female
  • Gene Rearrangement, T-Lymphocyte / genetics
  • HLA-DR4 Antigen / genetics
  • Humans
  • Killer Cells, Natural / immunology*
  • Lymphocyte Count
  • Lymphocyte Subsets / immunology
  • Male
  • Middle Aged
  • Receptors, Antigen, T-Cell, alpha-beta / analysis*
  • Receptors, Antigen, T-Cell, alpha-beta / genetics

Substances

  • Antibodies, Monoclonal
  • HLA-DR4 Antigen
  • Receptors, Antigen, T-Cell, alpha-beta