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Right atrial myxoma in a patient with systemic sclerosis: a paraneoplastic syndrome or the coexistence of two diseases connected to increase in interleukin 6
Abstract
The myxoma makes 80–90% of benign cardiac neoplasms. The first symptom in 50% of patients is an embolism resulting from relocation of tumor fragments or blood clots into the bloodstream. Elevated values of acute phase proteins in these patients are results of non-specific immune response to an antigen causing the disease. Interleukin 6 (IL-6) plays a role in this reaction, modifying inflammatory response by: influence on lymphocyte T differentiation, lymphocyte B to plasmocyte transformation, and stimulation of the liver to produce acute phase proteins. Elevated IL-6 is found in 80% of patients with diagnosed myxoma, which causes it to be an important marker in diagnostic and post-operational monitoring. The role in non-specific inflammatory response played by IL-6 in myxoma and autoimmune disorders was a cause of many diagnostic mistakes. Available literature does not suggest a coincidence of cardiac myxoma and systemic sclerosis. This is why we would like to present a case report, with special regard to correlation between IL-6 values and activity/stage of diagnosed disorders.
Keywords: myxomainterleukin 6
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- Roberts W. Primary and Secondary Neoplasms of the Heart. The American Journal of Cardiology. 1997; 80(5): 671–682.
- Perchinsky MJ, Lichtenstein SV, Tyers GF. Primary cardiac tumors: forty years' experience with 71 patients. Cancer. 1997; 79(9): 1809–1815.
- Sabatine M, Colucci W, Schoen F. Primary tumors of the heart. In: Braunwald E, Libby P, Zipes D, Bonow RO. ed. Braunwald’s heart disease. 7 th ed. Elsevier Masson, Philadelphia 2005.
- Jedliński I, Jamrozek-Jedlińska M, Bugajski P, et al. [Asymptomatic myxoma of the tricuspid valve septal leaflet]. Kardiol Pol. 2012; 70(6): 609–611.
- Reynen K. Frequency of primary tumors of the heart. The American Journal of Cardiology. 1996; 77(1): 107.
- Hövels-Gürich HH, Seghaye MC, Amo-Takyi BK, et al. Cardiac myxoma in a 6-year-old child--constitutional symptoms mimicking rheumatic disease and the role of interleukin-6. Acta Paediatr. 1999; 88(7): 786–788.
- Byrd WE, Matthews OP, Hunt RE. Left atrial myxoma presenting as a systemic vasculitis. Arthritis Rheum. 1980; 23(2): 240–243.
- Kanda T, Umeyama S, Sasaki A, et al. Interleukin-6 and cardiac myxoma. Am J Cardiol. 1994; 74(9): 965–967.
- Jakóbisiak M. Immunology . PWN, Warsaw 1998.
- Lis A, Brzezińska-Wcisło L. Serum interleukin-6 and 2 levels as a markers of scleroderma progress. Pol Merk Lek. 2001; 11: 206–209.
- Fitzpatrick AP, Lanham JG, Doyle DV. Cardiac tumours simulating collagen vascular disease. Br Heart J. 1986; 55(6): 592–595.
- Elikowski W, Pawelczyk K, Bielski K. Left atrial myxoma mimicking connective tissue disease. . Wiad. Lek. 1992; 21-22: 847–848.
- Needleman BW, Wigley FM, Stair RW. Interleukin-1, interleukin-2, interleukin-4, interleukin-6, tumor necrosis factor alpha, and interferon-gamma levels in sera from patients with scleroderma. Arthritis Rheum. 1992; 35(1): 67–72.
- Stuart RA, Littlewood AJ, Maddison PJ, et al. Elevated serum interleukin-6 levels associated with active disease in systemic connective tissue disorders. Clin Exp Rheumatol. 1995; 13(1): 17–22.