Treatment of primary Sjögren's syndrome with hydroxychloroquine

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Abstract

Sjögren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of the salivary/lacrimal glands, autoantibody production, and polyclonal hyperglobulinemia. In view of the efficacy and relative safety of hydroxychloroquine in other autoimmune disorders, the potential benefit of hydroxychloroquine (200 mg per day for 12 months) in 10 patients with Sjögren's syndrome was evaluated. Changes in levels of total immunoglobulin, antibody against Sjögren's syndrome-associated antigen B, rheumatoid factor, and in vitro production of immunoglobulin in the serum were evaluated. For comparison, 10 patients matched according to age and sex, who did not receive hydroxychloroquine were studied. In the hydroxychloroquine-treated group, the following observations were made: (1) significantly decreased total immunoglobulin G (IgG) and IgA levels with little change in IgM levels; (2) significant decrease in IgA-rheumatoid factor with a smaller decrease in IgM-rheumatoid factor; (3) decreased IgG anti-Sjögren's syndrome-associated antigen B autoantibody; and (4) decreased erythrocyte sedimentation rate and increased hemoglobin level. Further, a specific idiotype present on their rheumatoid factor (defined by monoclonal antibody 17-109) was significantly decreased, with disappearance of detectable circulating paraprotein in two hydroxychloroquine-treated patients. Finally, rheumatoid factor production in vitro by lymphocytes from hydroxychloroquine-treated patients using a T cell-dependent mitogen was significantly decreased. These results suggest that hydroxychloroquine modulates lymphoproliferation in patients with Sjögren's syndrome and may prevent progression to extraglandular sites of neoplastic transformation.

References (34)

  • S Kassan et al.

    Increased risk of lymphoma in sicca syndrome

    Ann Intern Med

    (1978)
  • H Moutsopoulos et al.

    High incidence of free light chains in the sera of patients with Sjögren's syndrome

    J Immunol

    (1983)
  • T Sugai et al.

    Non IgM monoclonal gammopathy in patients with Sjögren's syndrome

    Am J Med

    (1980)
  • RI Fox et al.

    Expression of a cross reactive idiotype on rheumatoid factor in patients with Sjögren's syndrome

    J Immunol

    (1986)
  • JF Payne

    A postgraduate lecture of lupus erythematosus

    Clin J

    (1894)
  • AS Cohen et al.

    A controlled study of chloroquine as an antirheumatic agent

    Arthritis Rheum

    (1958)
  • AW Bagnall

    The value of chloroquine in rheumatoid disease

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    This work is supported in part by NIH grants AR 33983 and RR 00833. This is publication number 5162BCR from the Research Institute of Scripps Clinic, La Jolla, California.

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