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lüll X linked agammaglobulinaemia and rheumatoid arthritis Verbruggen G; De Backer S; Deforce D; Demetter P; Cuvelier C; Veys E; Elewaut DAnn Rheum Dis 2005[Jul]; 64 (7): 1075-8BACKGROUND: Much interest has been shown recently in the pathogenic role of B cells in rheumatoid arthritis (RA) owing to the marked clinical responses to anti-CD20 treatment in RA. CASE REPORT: A patient with X linked agammaglobulinaemia (XLA) presented with an erosive symmetric polyarthritis with histological features of RA, including formation of a destructive pannus. Furthermore, the patient developed subcutaneous nodules that were histologically indistinguishable from rheumatoid nodules. Surprisingly, lymphocytic infiltrates in both the synovium and nodule consisted almost exclusively of CD8+ T cells. DISCUSSION: Although some peculiar B cell subsets have been described in patients with XLA, no B cell subsets could be demonstrated in synovial tissue or the subcutaneous nodule. This case illustrates that classical RA can develop in the absence of mature B cells.|Agammaglobulinemia/*genetics/*immunology[MESH]|Arthritis, Rheumatoid/diagnostic imaging/*immunology/pathology[MESH]|CD8-Positive T-Lymphocytes/*immunology[MESH]|Fatal Outcome[MESH]|Genetic Diseases, X-Linked/diagnostic imaging/*immunology/pathology[MESH]|Hand/diagnostic imaging[MESH]|Humans[MESH]|Lymphocyte Subsets[MESH]|Male[MESH]|Middle Aged[MESH]|Polymerase Chain Reaction[MESH]|Radiography[MESH] |