Трудности ведения больных системной красной волчанкой и антифосфолипидным синдромом в сочетании с меланомой и инфильтративным туберкулезом (клинические наблюдения)

Представлено два клинических наблюдения: в одном из них имелись антифосфолипидный синдромом (АФС) и меланома, в другом – системная красная волчанка (СКВ) и АФС, меланома, инфильтративный туберкулез и Herpes zoster. Ведение больных СКВ в сочетании с АФС – непростая задача. Инфекции и злокачественные новообразования наряду с поражением почек и сердечно-сосудистыми заболеваниями являются значимой причиной смерти в этой когорте больных. Продолжает обсуждаться роль антител к фосфолипидам в возникновении малигнизации. Сочетание ревматических заболеваний с онкологической или инфекционной патологией затрудняет терапию, ограничивая возможность применения препаратов, регламентированных клиническими рекомендациями.

1. Насонов ЕЛ, редактор. Российские клинические рекомендации. Ревматология. Москва: ГЭОТАР-Медиа; 2017. 464 с.

2. D'Cruz DP, Mellor-Pita S, Joven B, et al. Transverse myelitis as the first manifestation of systemic lupus erythematosus or lupus-like disease: good functional outcome and relevance of antiphospholipid antibodies. J Rheumatol. 2004 Feb;31(2):280-5.

3. Насонов ЕЛ. Антифосфолипидный синдром. Монография. Москва: Литтера; 2004. 36 с.

4. Решетняк ТМ. Антифосфолипидный синдром: диагностика и клинические проявления (лекция). Научно-практическая ревматология. 2014;52(1):56-71.

5. Ocampo-Piraquive V, Nieto-Aristizabal I, Canas CA, Tobon GJ. Mortality in systemic lupus erythematosus: causes, predictors and interventions. Expert Rev Clin Immunol. 2018 Dec;14(12):1043-53. doi: 10.1080/1744666X.2018.1538789.

6. Rodriguez-Pinto I, Moitinho M, Santacreu I, et al. Catastrophic antiphospholipid syndrome (CAPS): Descriptive analysis of 500 patients from the International CAPS Registry. Autoimmun Rev. 2016 Dec;15(12): 1120-4. doi: 10.1016/j.autrev.2016.09.010. Epub 2016 Sep 15.

7. Pettersson T, Pukkala E, Teppo L, Friman C. Increased risk of cancer in patients with systemic lupus erythematosus. Ann Rheum Dis. 1992 Apr;51(4):437-9. doi: 10.1136/ard.51.4.437.

8. Islam MA. Antiphospholipid antibodies and antiphospholipid syndrome in cancer: Uninvited guests in troubled times. Semin Cancer Biol. 2020 Aug;64:108-13. doi: 10.1016/j.semcancer.2019.07.019. Epub 2019 Jul 24.

9. Mendoza-Pinto C, Garcia-Carrasco M, Cervera R. Role of Infectious Diseases in the Antiphospholipid Syndrome (Including Its Catastrophic Variant). Curr Rheumatol Rep. 2018 Aug 20;20(10):62. doi: 10.1007/s11926-018-0773-x.

10. Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. Nov-Dec 2014;28(6):1005-11.

11. Rigel DS. Epidemiology of melanoma. Semin Cutan Med Surg. 2010 Dec;29(4): 204-9. doi: 10.1016/j.sder.2010.10.005.

12. Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005 Jan;41(1):45-60. doi: 10.1016/j.ejca.2004.10.016.

13. Cao L, Tong H, Xu G, et al. Systemic lupus erythematous and malignancy risk: a meta-analysis. PLoS One. 2015 Apr 17;10(4): e0122964. doi: 10.1371/journal.pone.0122964. eCollection 2015.

14. Singh AG, Crowson CS, Singh S, et al. Cancer risk in cutaneous lupus erythematosus: a population-based cohort study. Rheumatology (Oxford). 2016 Nov;55(11):2009-13. doi: 10.1093/rheumatology/kew291. Epub 2016 Aug 12.

15. Chow MT, Möller A, Smyth MJ. Inflammation and immune surveillance in cancer. Semin Cancer Biol. 2012 Feb;22(1): 23-32. doi: 10.1016/j.semcancer.2011.12.004. Epub 2011 Dec 24.

16. Yadav S, Singh S, Harmsen WS, et al. Effect of Medications on Risk of Cancer in Patients With Inflammatory Bowel Diseases: A Population-Based Cohort Study from Olmsted County, Minnesota. Mayo Clin Proc. 2015 Jun;90(6):738-46. doi: 10.1016/j.mayocp.2015.03.024. Epub 2015 May 9.

17. Trousseau A. Phlegmasia alba dolens Clinique Medical de L'HotelDieu de Paris. Vol. 3. London: The New Sydenham Society; 1865. 94 p.

18. Lee AY, Levine MN. Venous thromboembolism and cancer: risks and outcomes. Circulation. 2003 Jun 17;107(23 Suppl 1): I17-21. doi: 10.1161/01.CIR.0000078466.72504.AC.

19. Wuepper KD, Tuffanelli DL. False-positive reaction to VRDL test with prozone phenomena. Association with lymphosarcoma. JAMA. 1966 Mar 7;195(10):868-9. doi: 10.1001/jama.1966.03100100120044.

20. Schleider MA, Nachman RL, Jaffe EA, Coleman M. A clinical study of the lupus anticoagulant. Blood. 1976 Oct;48(4): 499-509.

21. Falcon CR, Hoffer AM, Carreras LO. Antiphosphatidylinositol antibodies as markers of the antiphospholipid syndrome. Thromb Haemost. 1990 Apr 12;63(2):321-2.

22. Stern JJ, Ng RH, Triplett DA, McIntyre JA. Incidence of antiphospholipid antibodies in patients with monoclonal gammopathy of undetermined significance. Am J Clin Pathol. 1994 Apr;101(4):471-4. doi: 10.1093/ajcp/101.4.471.

23. Zuckerman E, Toubi E, Golan TD, et al. Increased thromboembolic incidence in anticardiolipin-positive patients with malignancy. Br J Cancer. 1995 Aug; 72(2): 447-51. doi: 10.1038/bjc.1995.353.

24. Gomez-Puerta JA, Cervera R, Espinosa G, et al. Antiphospholipid antibodies associated with malignancies: clinical and pathological characteristics of 120 patients. Semin Arthritis Rheum. 2006 Apr;35(5):322-32. doi: 10.1016/j.semarthrit.2005.07.003.

25. Choi MY, Flood K, Bernatsky S, Ramsey-Goldman R, Clarke AE. A review on SLE and malignancy. Best Pract Res Clin Rheumatol. 2017 Jun;31(3):373-396. doi: 10.1016/j.berh.2017.09.013.

26. Song L, Wang Y, Zhang J, et al. The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and meta-analysis. Arthritis Res Ther. 2018 Dec 6;20(1):270. doi: 10.1186/s13075-018-1760-3.

27. Jacobs JVG, Bijlsma JVG. Glucocorticoid therapy. In Firestein GS, Budd RC, Gabriel SE, editors. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia: Elsevier; 2017. P. 932-57.

28. Яблонский ПК, редактор. Фтизиатрия. Национальные клинические рекомендации. Москва: ГЭОТАР-Медиа; 2016. 240 с.

29. Ghosh K, Patwardhan M, Pradhan V. Mycobacterium tuberculosis infection precipitates SLE in patients from endemic areas. Rheumatol Int. 2009 Jul;29(9):1047-50. doi: 10.1007/s00296-009-0903-x. Epub 2009 Apr 10.

30. Hernandez-Cruz B, Sifuentes-Osornio J, Ponce-de-Leon Rosales S, et al. Mycobacterium tuberculosis infection in patients with systemic rheumatic diseases. A case-series. Clin Exp Rheumatol. 1999 May-Jun;17(3): 289-96.

31. Park DW, Chung SJ, Yeo Y, et al. Therapeutic issues with, and long-term outcomes of, pulmonary mycobacterial tuberculosis treatment in patients with autoimmune rheumatic diseases. J Thorac Dis. 2019 Nov; 11(11):4573-82. doi: 10.21037/jtd.2019.10.74.

32. Gatto M, Saccon F, Zen M, et al. Success and failure of biological treatment in systemic lupus erythematosus: A critical analysis. J Autoimmun. 2016 Nov;74:94-105. doi: 10.1016/j.jaut.2016.06.014. Epub 2016 Jun 30.

33. Stohl W, Schwarting A, Okada M, et al. Efficacy and Safety of Subcutaneous Belimumab in Systemic Lupus Erythematosus: A Fifty-Two-Week Randomized, Double-Blind, Placebo-Controlled Study. Arthritis Rheumatol. 2017 May;69(5):1016-27. doi: 10.1002/art.40049. Epub 2017 Apr 7.

34. Diaz-Lagares C, Perez-Alvarez R, Garcia-Hernandez FJ, et al. Rates of, and risk factors for, severe infections in patients with systemic autoimmune diseases receiving biological agents off-label. Arthritis Res Ther. 2011 Jul 11;13(4):R112. doi: 10.1186/ar3397.