Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis

The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). She was found to be positive for anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies....

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Autores principales: Takajo, Ichiro, Umekita, Kunihiko, Ikei, Yoshihiko, Oshima, Koichi, Okayama, Akihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096007/
https://www.ncbi.nlm.nih.gov/pubmed/29491299
http://dx.doi.org/10.2169/internalmedicine.0308-17
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author Takajo, Ichiro
Umekita, Kunihiko
Ikei, Yoshihiko
Oshima, Koichi
Okayama, Akihiko
author_facet Takajo, Ichiro
Umekita, Kunihiko
Ikei, Yoshihiko
Oshima, Koichi
Okayama, Akihiko
author_sort Takajo, Ichiro
collection PubMed
description The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). She was found to be positive for anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies. Her symptoms and laboratory abnormalities spontaneously regressed after the cessation of methotrexate (MTX), suggesting that she had an MTX-associated lymphoproliferative disorder; however, her lymphadenopathy appeared again approximately 14 months later with LD and sIL-2R elevation. A histopathological analysis and Southern blotting of a lymph node biopsy specimen for HTLV-1 provirus supported the diagnosis of adult T-cell leukemia/lymphoma (ATL) (lymphoma type). These data confirmed that an HTLV-1 positive RA patient may develop ATL.
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spelling pubmed-60960072018-08-17 Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis Takajo, Ichiro Umekita, Kunihiko Ikei, Yoshihiko Oshima, Koichi Okayama, Akihiko Intern Med Case Report The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). She was found to be positive for anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies. Her symptoms and laboratory abnormalities spontaneously regressed after the cessation of methotrexate (MTX), suggesting that she had an MTX-associated lymphoproliferative disorder; however, her lymphadenopathy appeared again approximately 14 months later with LD and sIL-2R elevation. A histopathological analysis and Southern blotting of a lymph node biopsy specimen for HTLV-1 provirus supported the diagnosis of adult T-cell leukemia/lymphoma (ATL) (lymphoma type). These data confirmed that an HTLV-1 positive RA patient may develop ATL. The Japanese Society of Internal Medicine 2018-02-28 2018-07-15 /pmc/articles/PMC6096007/ /pubmed/29491299 http://dx.doi.org/10.2169/internalmedicine.0308-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Takajo, Ichiro
Umekita, Kunihiko
Ikei, Yoshihiko
Oshima, Koichi
Okayama, Akihiko
Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title_full Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title_fullStr Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title_full_unstemmed Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title_short Adult T-cell Leukemia/Lymphoma as a Methotrexate-associated Lymphoproliferative Disorder in a Patient with Rheumatoid Arthritis
title_sort adult t-cell leukemia/lymphoma as a methotrexate-associated lymphoproliferative disorder in a patient with rheumatoid arthritis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096007/
https://www.ncbi.nlm.nih.gov/pubmed/29491299
http://dx.doi.org/10.2169/internalmedicine.0308-17
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