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rheumatoid arthritis mtx lymphoproliferative

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https://www.readbyqxmd.com/read/28679993/iatrogenic-immunodeficiency-associated-epstein-barr-virus-ebv-negative-natural-killer-cell-lymphoproliferative-disorder-in-a-patient-undergoing-rheumatoid-arthritis-therapy
#1
Tomoyuki Uchida, Morihiro Inoue, Jian Hua, Shogo Tajima, Yasunori Ota, Masao Hagihara
Here we present a patient with rheumatoid arthritis (RA), who was suspected to have developed malignant lymphoma during immunosuppressive therapy 5 years earlier. She temporarily achieved remission after discontinuing therapy; however, her disease worsened with remittent fever and splenomegaly. Splenic biopsy demonstrated infiltration by abnormal cells, which were positive for CD56 and T cell intracytoplasmic antigen, but negative for CD3 and Epstein-Barr virus (EBV) -encoded RNA. Cytogenetic analysis of bone marrow and lumbar spine tumor revealed common complex karyotype abnormalities...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28676912/clinical-characteristics-of-methotrexate-associated-lymphoproliferative-disorders-relationship-between-absolute-lymphocyte-count-recovery-and-spontaneous-regression
#2
Satoshi Takanashi, Yoshinobu Aisa, Chisako Ito, Hideki Arakaki, Yuki Osada, Yuichiro Amano, Motoharu Hirano, Tomonori Nakazato
Several reports have shown that patients with rheumatoid arthritis (RA) are at increased risk of developing lymphoproliferative disorders (LPD). Methotrexate (MTX) has been recognized as a major cause of LPD. Sometimes spontaneous regression (SR) occurs after withdrawal of MTX. Recent studies suggest that the early recovery of the absolute lymphocyte count (ALC) after withdrawal of MTX is associated with the spontaneous regression of MTX-LPD. We retrospectively analyzed 26 patients with MTX-LPD to identify predictive factors for spontaneous regression...
July 5, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28654766/methotrexate-related-lymphoproliferative-disorder-in-patients-with-osteonecrosis-of-the-jaw-a-3-case-report-and-literature-review
#3
Ken Furudate, Anna Satake, Norihiko Narita, Wataru Kobayashi
Patients with immunodeficiency or immunosuppression are at risk of developing a lymphoproliferative disorder (LPD). Methotrexate (MTX) is an iatrogenic cause of LPD, which in up to 50% cases occurs in extranodal sites. The occurrence of MTX-related LPD with osteonecrosis of the jaw (ONJ) has rarely been reported. Moreover, there are no clear diagnostic criteria and treatment strategies for management of these lesions. In the present cases, discontinuing MTX and debridement of the necrotic bone were effective...
June 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28507640/histopathological-features-of-methotrexate-induced-pulmonary-lesions-in-rheumatoid-arthritis-patients-a-systematic-review-of-case-reports
#4
REVIEW
Anthony Thaniyan, Foad F A Ayman, Hyder O Mirghani, Badr A Al-Sayed, Tarig H Merghani
BACKGROUND: Methotrexate (MTX) is the most commonly used disease-modifying drug in the treatment of rheumatoid arthritis (RA); however, it causes many side effects, including pulmonary lesions. In this review, we characterised the histopathological features of MTX-induced pulmonary lesions in RA patients. AIM: We carried out an electronic search of the relevant literature published during the period from 1990 to 2016. We included only the cases with definitive histo-pathological findings caused by MTX therapy...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28484154/spontaneous-regression-of-methotrexate-related-diffuse-large-b-cell-lymphoma-following-bladder-lesion-resection
#5
Michiko Yamada, Hiroyuki Kuroda, Ken Sato, Shogo Miura, Saki Ameda, Hiroya Sakano, Takanori Shibata, Naoki Uemura, Tomoyuki Abe, Shigeyuki Fujii, Masahiro Maeda, Miri Fujita, Junji Kato
A 71-year-old woman who had been treated with methotrexate (MTX) and prednisolone for rheumatoid arthritis since 2010 presented with hematuria. Cystitis was diagnosed. Chest and abdominal CT images revealed a bladder tumor, with lung and bilateral adrenal metastases. Transurethral resection of the bladder tumor (TUR-BT) confirmed these findings in September 2014. Histological findings of the bladder included large atypical lymphoid cells indicating diffuse large B-cell lymphoma. After TUR-BT, CT imaging showed that the tumor had shrunk...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28455827/characteristics-and-risk-factors-of-lymphoproliferative-disorders-among-patients-with-rheumatoid-arthritis-concurrently-treated-with-methotrexate-a-nested-case-control-study-of-the-iorra-cohort
#6
Yoko Shimizu, Ayako Nakajima, Eisuke Inoue, Kumi Shidara, Naoki Sugimoto, Yohei Seto, Eiichi Tanaka, Shigeki Momohara, Atsuo Taniguchi, Hisashi Yamanaka
The purpose of the study is to demonstrate the characteristics of lymphoproliferative disorders (LPDs) in patients with rheumatoid arthritis (RA) and risk factors for LPD among RA patients concurrently treated with methotrexate (MTX). Among patients who participated in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort study in October 2010, past existence of LPD from patient's report was confirmed through medical charts. Background factors, LPD pathological findings, and the clinical courses of LPD and RA after LPD were assessed...
June 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28380678/clinicopathological-analysis-of-methotrexate-associated-lymphoproliferative-disorders-comparison-of-diffuse-large-b-cell-lymphoma-and-classical-hodgkin-lymphoma-types
#7
Yuka Gion, Noriko Iwaki, Katsuyoshi Takata, Mai Takeuchi, Keiichiro Nishida, Yorihisa Orita, Tomoyasu Tachibana, Tadashi Yoshino, Yasuharu Sato
Patients with rheumatoid arthritis often develop methotrexate-associated lymphoproliferative disorders (MTX-LPD) during MTX treatment. MTX-LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non-spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX-LPD (diffuse large B-cell lymphoma [DLBCL]-type [n = 34] and classical Hodgkin lymphoma [CHL]-type [n = 17])...
June 2017: Cancer Science
https://www.readbyqxmd.com/read/28331131/the-aggressive-clinical-courses-of-hodgkin-lymphoma-primarily-diagnosed-as-methotrexate-induced-non-specific-lymphoproliferative-disorder-in-patients-with-rheumatoid-arthritis
#8
Michihide Tokuhira, Takayuki Tabayashi, Yuka Tanaka, Yasuyuki Takahashi, Yuta Kimura, Tatsuki Tomikawa, Tomoe Anan-Nemoto, Shuju Momose, Morihiro Higashi, Ayumi Okuyama, Reiko Watanabe, Koichi Amano, Jun-Ichi Tamaru, Masahiro Kizaki
Recently, attention has been focused on methotrexate-induced lymphoproliferative disease (MTX-LPD), and atypical phenotypes are occasionally documented. We encountered two patients with rheumatoid arthritis (RA) who were diagnosed with non-specific LPD (LPD-nos). Biopsy samples were not obtained during the initial examination when the LPD development was discovered, and the patients achieved a complete response after MTX cessation (case 1) or steroid pulse therapy (case 2). However, the tumors flared up 1.5 years later, and LPD-nos was determined following biopsies of the lymph node (LN, case 1) and liver (case 2)...
2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/28199343/long-term-treatment-with-abatacept-or-tocilizumab-does-not-increase-epstein-barr-virus-load-in-patients-with-rheumatoid-arthritis-a-three-years-retrospective-study
#9
Nathalie Balandraud, Gaetan Texier, Emmanuel Massy, Olivier Muis-Pistor, Marielle Martin, Isabelle Auger, Marie-Caroline Guzian, Sandrine Guis, Thao Pham, Jean Roudier
BACKGROUND: Epstein-Barr Virus (EBV) is a widely disseminated lymphotropic herpes virus implicated in benign and malignant disorders. In transplant patients, immunosuppressive drugs (cyclosporine) diminish control of EBV replication, potentially leading to lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) patients have impaired control of EBV infection and have EBV load ten times higher than controls. As post transplant patients, patients with RA have increased risk of developing lymphomas...
2017: PloS One
https://www.readbyqxmd.com/read/28196776/ebv-induced-lymphoproliferative-disorders-in-rheumatic-patients-a-systematic-review-of-the-literature
#10
Alvise Berti, Mara Felicetti, Susanna Peccatori, Roberto Bortolotti, Anna Guella, Paolo Vivaldi, Luca Morelli, Mattia Barabareschi, Giuseppe Paolazzi
OBJECTIVES: Epstein-Barr virus (EBV) is involved in the pathogenesis of approximately 40% of lymphoproliferative disorders (LPDs) arising in patients receiving immunosuppressive treatment (IST) for rheumatic diseases, but data from large cohorts are still not available. We aimed to identify clinicopathological features, management and outcome of this condition. METHODS: We reviewed all published cases of EBV-encoded RNA (EBER)-positive LPDs and included in our analysis one unpublished patient diagnosed in our Hospital...
February 11, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28165538/distinct-patterns-of-lymphocyte-count-transition-in-lymphoproliferative-disorder-in-patients-with-rheumatoid-arthritis-treated-with-methotrexate
#11
Shuntaro Saito, Yuko Kaneko, Kunihiro Yamaoka, Michihide Tokuhira, Tsutomu Takeuchi
Objective.: To clarify the characteristics of lymphoproliferative disorder (LPD) in patients with RA treated with MTX. Methods.: Among 33 patients developing LPD during MTX treatment, 20 LPDs regressed spontaneously within 12 weeks after MTX cessation (regressive LPD), and 13 did not regress and most of them died or needed chemotherapy (persistent LPD). The control group consisted of 66 clinically matched MTX-treated RA patients without LPD. The clinical characteristics were compared between these three groups...
June 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28076752/methotrexate-associated-primary-hepatic-malignant-lymphoma-following-hepatectomy-a-case-report
#12
Daisuke Takei, Tomoyuki Abe, Hironobu Amano, Naomichi Hirano, Tsuyoshi Kobayashi, Hideki Ohdan, Toshinori Kondo, Masahiro Nakahara, Toshio Noriyuki
INTRODUCTION: Recently, immunosuppressant-associated malignant lymphoma (ML) cases have been increasing along with the development of several effective immunosuppressant drugs for rheumatoid arthritis (RA). Among methotrexate (MTX)-associated lymphoproliferative disorders, primary hepatic lymphoma (PHL) in patients with RA following surgical resection has not been reported previously. PRESENTATION OF CASE: A 65-year-old woman who is a hepatitis B virus carrier with a history of RA was admitted...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27957282/atypical-methotrexate-ulcerative-stomatitis-with-features-of-lymphoproliferative-like-disorder-report-of-a-rare-ciprofloxacin-induced-case-and-review-of-the-literature
#13
Nikolaos Katsoulas, Evanthia Chrysomali, Evangelia Piperi, Georgia Levidou, Alexandra Sklavounou-Andrikopoulou
Methotrexate (MTX) is an established immunomodulating agent used in low doses (LDMTX) to treat several autoimmune diseases. Ulcerative stomatitis (US) may be observed as a long-term LDMTX adverse effect showing a wide histopathologic spectrum. A 73-year old female presented with painful oral ulcers of 5 days duration. The patient had been under treatment for rheumatoid arthritis with LDMTX, while one week before presentation she was prescribed ciprofloxacin for a urinary infection. Histopathologic examination of a lingual ulcer revealed a polymorphous lymphohistiocytic proliferation with scattered binucleated atypical lymphocytes...
December 2016: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/27864689/epstein-barr-virus-infection-and-gene-promoter-hypermethylation-in-rheumatoid-arthritis-patients-with-methotrexate-associated-b-cell-lymphoproliferative-disorders
#14
Kozue Ejima-Yamada, Yumi Oshiro, Seiichi Okamura, Tomoaki Fujisaki, Yasuhito Mihashi, Kazuo Tamura, Tomoko Fukushige, Masaru Kojima, Kazutoshi Shibuya, Morishige Takeshita
We analyzed CpG-island hypermethylation status in 12 genes of paraffin-embedded tissues from 38 rheumatoid arthritis (RA) patients with methotrexate (MTX)-associated large B cell lymphoproliferative disorder (BLPD), 11 RA patients with non-MTX-associated BLPD (non-MTX-BLPD), 22 controls with diffuse large B cell lymphoma (DLBCL), and 10 controls with Epstein-Barr virus (EBV)(+) DLBCL. Among them, tumor cells from EBV(+) MTX-BLPD patients and control EBV(+) DLBCL patients had significantly lower median incidence of CpG island methylator phenotype (CIMP) than those from non-MTX-BLPD and control DLBCL groups (2...
February 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27846761/prognostic-factors-of-methotrexate-associated-lymphoproliferative-disorders-associated-with-rheumatoid-arthritis-and-plausible-application-of-biological-agents
#15
Takayuki Katsuyama, Ken-Ei Sada, Minglu Yan, Sonia Zeggar, Sumie Hiramatsu, Yoshia Miyawaki, Keiji Ohashi, Michiko Morishita, Haruki Watanabe, Eri Katsuyama, Mariko Takano-Narazaki, Noriko Toyota-Tatebe, Katsue Sunahori-Watanabe, Tomoko Kawabata, Kohei Miyake, Toru Kiguchi, Jun Wada
OBJECTIVES: To determine prognostic factors of methotrexate-associated lymphoproliferative disorder (MTX-LPD) and evaluate the efficacy and safety of biological therapy in rheumatoid arthritis (RA) complicated with MTX-LPD. METHODS: Thirty RA patients who developed MTX-LPD were investigated in this study. We compared the clinical and laboratory parameters of patients who achieved regression of LPD by MTX withdrawal with those who required chemotherapy and evaluated the clinical course of RA after LPD development...
December 15, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27785332/epstein-barr-virus-positive-diffuse-large-b-cell-lymphoma-involving-the-colon-in-a-patient-with-ulcerative-pancolitis-and-polymyositis-on-long-term-methotrexate-therapy
#16
Michael D Chang, Merry-Jennifer Markham, Xiuli Liu
The link between immunosuppressive therapy and increased lymphoma risk is well established in patients with solid organ transplantation. Epstein-Barr virus-positive (EBV) diffuse large B-cell lymphoma (DLBCL) is known to be a complication in patients receiving methotrexate for rheumatoid arthritis, and the risk of lymphoma in inflammatory bowel disease (IBD) has raised concerns regarding the lymphoproliferative potential of immunomodulatory therapy. In this report, we describe a case of EBV-positive DLBCL arising within the colon of a patient affected by ulcerative pancolitis...
October 2016: Gastroenterology Research
https://www.readbyqxmd.com/read/27577564/a-case-of-multiple-hepatic-lesions-associated-with-methotrexate-associated-lymphoproliferative-disorder
#17
Ruby Matsumoto, Kazushi Numata, Nobutaka Doba, Koji Hara, Makoto Chuma, Hiroyuki Fukuda, Akito Nozaki, Katsuaki Tanaka, Yoshimi Ishii, Shin Maeda
Patients receiving methotrexate (MTX) for the treatment of autoimmune disease are at a high risk of developing lymphoproliferative disorders (LPD), the so-called methotrexate-associated lymphoproliferative disorders (MTX-LPD). We recently performed abdominal ultrasonography (US) in a patient with rheumatoid arthritis (RA) who had developed hepatic dysfunction during the course of MTX therapy; the examination revealed multiple well-demarcated hepatic tumors with slightly irregular borders, the largest one measuring 9 cm in diameter...
October 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27523005/other-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorder-presenting-as-primary-bone-lymphoma-in-a-patient-with-rheumatoid-arthritis
#18
Kazuya Ishiguro, Toshiaki Hayashi, Yuka Aoki, Rieko Murakami, Hiroshi Ikeda, Tadao Ishida
Primary bone lymphoma (PBL) is a rare disorder. We herein present a case of other iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) presenting as PBL. A 63-year-old woman was diagnosed with rheumatoid arthritis and had been treated with methotrexate for seven years. Two months before admission, she suffered from pain in the limbs. Magnetic resonance imaging revealed multiple irregular lesions in the bones of the limbs, which showed an uptake of (18)F-FDG on positron emission tomography...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27459820/-four-cases-of-other-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorders-in-the-head-and-neck-region
#19
REVIEW
Masahiko Fukasawa, Yoshihiro Akazawa, Shigeru Kasugai, Koshi Mikami, Yoshimitsu Saito, Masatoshi Akutsu, Aibi Akashi, Kojiro Ido, Ichiro Maeda, Masahiro Hoshikawa, Izumi Koizuka
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD) comprise lymphoid proliferations or lymphomas that arise in patients treated with immunosuppressive drugs for autoimmune diseases, especially rheumatoid arthritis (RA) treated with methotrexate (MTX). MTX has been increasingly administered to patients with RA, resulting in methotrexate-associated lymphoproliferative disorder (MTX-LPD) in patients. We report herein on four cases of patients with RA, who diagnosed with head and neck region...
May 2016: Nihon Jibiinkoka Gakkai Kaiho
https://www.readbyqxmd.com/read/27335685/methotrexate-associated-primary-cutaneous-cd30-positive-cutaneous-t-cell-lymphoproliferative-disorder-a-case-illustration-and-a-brief-review
#20
Wederson M Claudino, Bradley Gibson, William Tse, Maxwell Krem, Jaspreet Grewal
Methotrexate (MTX) is a commonly used anti-metabolite agent. Increased risk of lymphoproliferative disorders (LPD) in patients with rheumatoid arthritis (RA) has been documented with the prolonged use of immunosuppressive medications such as MTX. This is thought to be the result of immune dysregulation and/or chronic immune stimulation. Most cases of LPDs regress following withdrawal of the offending immunosuppressive agent. We present an interesting and rare case of CD30 and EBV positive CD8 primary cutaneous anaplastic large cell lymphoma (PC-ALCL) in a 66-year-old African American woman...
2016: American Journal of Blood Research
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