Hypereosinophilia and Seroconversion of Rheumatoid Arthritis

Rachel K. Rosenstein, Richard S. Panush, Neil Kramer, Elliot Rosenstein

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

At the intersection of atopy and autoimmunity, we present a patient with seronegative rheumatoid arthritis (RA) who developed hypereosinophilia, without evidence of other etiologies, as she became rheumatoid factor (RF) positive. Although the magnitude of eosinophilia in patients with RA has been thought to reflect the severity or activity of the RA, in our patient, eosinophilia developed at a time when the patient’s synovitis was well controlled. Although eosinophilia may reflect associated drug hypersensitivity, discontinuation of the medications utilized to control our patient’s disease, adalimumab and methotrexate, did not promote clinical improvement. Probably the most curious aspect of our patient was the concomitant development of rheumatoid factor seropositivity in the setting of previously seronegative RA. The temporal relationship between the development of peripheral eosinophilia and seroconversion suggests a possible connection between these events. We speculate that the T cell cytokine production that can induce eosinophilia may simultaneously activate RF production.

Original languageEnglish (US)
Pages (from-to)1685-1688
Number of pages4
JournalClinical Rheumatology
Volume33
Issue number11
DOIs
StatePublished - Oct 10 2014
Externally publishedYes

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Eosinophilia
Rheumatoid Arthritis
Rheumatoid Factor
Drug Hypersensitivity
Synovitis
Autoimmunity
Methotrexate
Seroconversion
Cytokines
T-Lymphocytes

All Science Journal Classification (ASJC) codes

  • Rheumatology

Cite this

Rosenstein, Rachel K. ; Panush, Richard S. ; Kramer, Neil ; Rosenstein, Elliot. / Hypereosinophilia and Seroconversion of Rheumatoid Arthritis. In: Clinical Rheumatology. 2014 ; Vol. 33, No. 11. pp. 1685-1688.
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Hypereosinophilia and Seroconversion of Rheumatoid Arthritis. / Rosenstein, Rachel K.; Panush, Richard S.; Kramer, Neil; Rosenstein, Elliot.

In: Clinical Rheumatology, Vol. 33, No. 11, 10.10.2014, p. 1685-1688.

Research output: Contribution to journalReview article

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AU - Rosenstein, Elliot

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AB - At the intersection of atopy and autoimmunity, we present a patient with seronegative rheumatoid arthritis (RA) who developed hypereosinophilia, without evidence of other etiologies, as she became rheumatoid factor (RF) positive. Although the magnitude of eosinophilia in patients with RA has been thought to reflect the severity or activity of the RA, in our patient, eosinophilia developed at a time when the patient’s synovitis was well controlled. Although eosinophilia may reflect associated drug hypersensitivity, discontinuation of the medications utilized to control our patient’s disease, adalimumab and methotrexate, did not promote clinical improvement. Probably the most curious aspect of our patient was the concomitant development of rheumatoid factor seropositivity in the setting of previously seronegative RA. The temporal relationship between the development of peripheral eosinophilia and seroconversion suggests a possible connection between these events. We speculate that the T cell cytokine production that can induce eosinophilia may simultaneously activate RF production.

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