Double Trouble: Malignancy and Systemic Rheumatic Diseases: A Single-Center Retrospective Observational Study from South India

Kottu Lakshmi Tejaswi, Rajeswari S., Balaji C., Nidhi Ramesh Prabhu, Vishwaprakash T., Sharmin Menon

Abstract: Background: A complex bidirectional relationship exists between malignancy and systemic autoimmune rheumatic diseases (SARDs). Chronic inflammation, immunosuppressive therapies, and impaired immune surveillance increase malignancy risk in SARDs, while cancer and its therapies can induce autoimmune manifestations. Objective: To identify the common malignancies in rheumatic diseases and paraneoplastic rheumatic manifestations of malignancy. Methods: This retrospective observational study was conducted at a tertiary care center in South India from January 2018 to July 2024. Patients with coexisting systemic rheumatic disease and malignancy were identified through hospital records. Data on demographics, disease characteristics, antibody profiles, treatments, and outcomes were collected and analyzed. Results: Thirty-four patients (93% female; mean age 52.5 ? 14.1 years) were included. Reproductive cancers were most common (59%), with cervical (26%) and breast (21%) cancers predominating. Hematological malignancies (12%) and colorectal cancers (12%) were also observed. Rheumatoid arthritis (RA) was the most frequent autoimmune diagnosis (41%), followed by systemic lupus erythematosus, dermatomyositis, and systemic sclerosis. Systemic rheumatic disease preceded malignancy in 51.3% of cases (median interval: 6.5 years), developed after malignancy in 31% (median interval: 5 years), or was diagnosed concurrently in 17.3%. Five patients (15%) had paraneoplastic rheumatic manifestations including inflammatory arthritis, dermatomyositis, and complex regional pain syndrome. Notable autoantibodies included RF, anti-CCP, RO52, Scl-70, and anti-TIF-1?. Two patients died during follow-up. Conclusion: Reproductive tract malignancies are the most frequently associated cancers in South Indian patients with systemic rheumatic diseases. Autoantibody profiles and timing of disease onset provide valuable clues in suspecting malignancy in SARDs. Heightened clinical vigilance is essential for early malignancy detection and for recognizing paraneoplastic rheumatic syndromes in such patients.

Keywords: Systemic autoimmune rheumatic diseases (SARDs), Malignancy, Paraneoplastic syndromes, Autoantibodies

How to Cite?: Kottu Lakshmi Tejaswi, Rajeswari S., Balaji C., Nidhi Ramesh Prabhu, Vishwaprakash T., Sharmin Menon, "Double Trouble: Malignancy and Systemic Rheumatic Diseases: A Single-Center Retrospective Observational Study from South India", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 842-846, https://www.ijsr.net/getabstract.php?paperid=SR25709100957, DOI: https://dx.doi.org/10.21275/SR25709100957