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Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case

We herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred withi...

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Autores principales: Hagihara, Masao, Mese, Toru, Ohara, Shin, Hua, Jian, Ide, Shiro, Inoue, Morihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232033/
https://www.ncbi.nlm.nih.gov/pubmed/29780139
http://dx.doi.org/10.2169/internalmedicine.0875-18
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author Hagihara, Masao
Mese, Toru
Ohara, Shin
Hua, Jian
Ide, Shiro
Inoue, Morihiro
author_facet Hagihara, Masao
Mese, Toru
Ohara, Shin
Hua, Jian
Ide, Shiro
Inoue, Morihiro
author_sort Hagihara, Masao
collection PubMed
description We herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL. The patient received a rituximab-containing chemotherapy and achieved complete remission.
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spelling pubmed-62320332018-11-13 Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case Hagihara, Masao Mese, Toru Ohara, Shin Hua, Jian Ide, Shiro Inoue, Morihiro Intern Med Case Report We herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL. The patient received a rituximab-containing chemotherapy and achieved complete remission. The Japanese Society of Internal Medicine 2018-05-18 2018-10-15 /pmc/articles/PMC6232033/ /pubmed/29780139 http://dx.doi.org/10.2169/internalmedicine.0875-18 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 journal 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
Hagihara, Masao
Mese, Toru
Ohara, Shin
Hua, Jian
Ide, Shiro
Inoue, Morihiro
Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title_full Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title_fullStr Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title_full_unstemmed Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title_short Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case
title_sort methotrexate-associated intravascular large b-cell lymphoma in a patient with rheumatoid arthritis: a very rare case
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232033/
https://www.ncbi.nlm.nih.gov/pubmed/29780139
http://dx.doi.org/10.2169/internalmedicine.0875-18
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