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Circulating immunoblasts in polymyalgia rheumatica

A A Eghtedari, W Esselinckx, P A Bacon

    Annals of the Rheumatic Diseases
    |April 1, 1976
    PubMed
    Summary
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    Elevated immunoblasts in peripheral blood are common in polymyalgia rheumatica (PMR) and correlate with disease activity. Detecting these cells aids in assessing PMR activity, especially with low erythrocyte sedimentation rates (ESR).

    Area of Science:

    • Immunology
    • Rheumatology
    • Clinical Medicine

    Background:

    • Polymyalgia rheumatica (PMR) is an inflammatory condition.
    • The role of circulating immunoblasts in PMR is not well understood.
    • Assessing PMR disease activity can be challenging, particularly with low erythrocyte sedimentation rates (ESR).

    Purpose of the Study:

    • To investigate the prevalence of circulating immunoblasts in patients with polymyalgia rheumatica (PMR).
    • To determine if the presence and levels of circulating immunoblasts correlate with PMR disease activity.
    • To evaluate the utility of detecting circulating immunoblasts as a biomarker for PMR.

    Main Methods:

    • Peripheral blood samples were collected from 29 patients with PMR and control groups.
    • The percentage of circulating immunoblasts was quantified.

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  • Correlation analysis was performed between immunoblast levels, erythrocyte sedimentation rate (ESR), and clinical assessment of disease activity.
  • Serial studies were conducted on some patients, including during steroid therapy.
  • Main Results:

    • A significantly higher proportion of PMR patients (18/29) had elevated circulating immunoblasts compared to healthy young controls (<0.5%) and elderly controls (1/12).
    • The presence of circulating immunoblasts strongly correlated with disease activity, as measured by ESR and clinical evaluation.
    • Initiation of steroid therapy led to a concurrent decrease in both ESR and circulating immunoblasts.
    • Elevated immunoglobulins were more frequent in PMR patients with circulating immunoblasts.

    Conclusions:

    • Circulating immunoblasts are frequently detected in polymyalgia rheumatica (PMR) patients and indicate active disease.
    • Measuring circulating immunoblasts can serve as a valuable additional tool for assessing PMR activity, especially when ESR is low.
    • The findings support an immunological basis for PMR and suggest a potential role for immunoblasts in its pathogenesis.