Lymphocyte subsets associated with T cell receptor β‐chain gene rearrangement in patients with rheumatoid arthritis and neutropenia

Objective. To determine the incidence of a clonal lymphoid disease in patients with chronic rheumatoid arthritis (RA) and neutropenia. Methods. Lymphocytes from 23 RA patients with either current neutropenia or a history of this complication were studied. Results. Eight patients had a clonal rearrangement of the T cell receptor β‐chain gene. Phenotypically, they showed a distinctive pattern characterized by an inverted CD4+:CD8+ cell ratio and an increased number and percentage of CD57+/CD8+ and CD3+/DR+ lymphocytes. None had evidence of a lymphoid malignancy. Conclusion. Among RA patients with neutropenia, there is a subset who have a subclinical disease resembling T γ lymphoproliferative disease.