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rheumatoid arthritis mtx lymphoproliferative

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https://www.readbyqxmd.com/read/29738359/genomic-profile-and-pathologic-features-of-diffuse-large-b-cell-lymphoma-subtype-of-methotrexate-associated-lymphoproliferative-disorder-in-rheumatoid-arthritis-patients
#1
Joaquim Carreras, Yara Yukie Kikuti, Masashi Miyaoka, Shinichiro Hiraiwa, Sakura Tomita, Haruka Ikoma, Yusuke Kondo, Sawako Shiraiwa, Kiyoshi Ando, Shinji Sato, Yasuo Suzuki, Ikuo Miura, Giovanna Roncador, Naoya Nakamura
Rheumatoid arthritis patients often develop the diffuse large B-cell lymphoma subtype of methotrexate-associated lymphoproliferative disorder (DLBCL). We characterized the genomic profile and pathologic characteristics of 20 biopsies using an integrative approach. DLBCL was associated with extranodal involvement, a high/high-intermediate international prognostic index in 53% of cases, and responded to MTX withdrawal. The phenotype was nongerminal center B-cell in 85% of samples and Epstein-Barr encoding region positive (EBER) in 65%, with a high proliferation index and intermediate MYC expression levels...
May 5, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29721441/indolent-t-cell-large-granular-lymphocytic-leukaemia-in-a-dog-presenting-with-severe-neutropenia-and-an-absence-of-lymphocytosis
#2
James Elliott, Elizabeth Villiers
In humans, large granular lymphocytic leukaemia (LGLL) is a low-grade, indolent lymphoproliferative disorder of large granular lymphocytes (LGL) associated with autoimmune disorders; including rheumatoid arthritis and single or multiple cytopenias; particularly neutropenia. Therapy largely centres around immunosuppression which aims to resolve the immune-mediated secondary pathology, often without eradicating the neoplastic clone. The most effective agents appear to be cyclophosphamide, cyclosporine and methotrexate...
2018: Open Veterinary Journal
https://www.readbyqxmd.com/read/29718746/japan-college-of-rheumatology-guideline-for-the-use-of-methotrexate-in-patients-with-rheumatoid-arthritis
#3
Hideto Kameda, Takao Fujii, Ayako Nakajima, Ryuji Koike, Akira Sagawa, Katsuaki Kanbe, Tetsuya Tomita, Masayoshi Harigai, Yasuo Suzuki
Methotrexate (MTX), the anchor drug in the current treatment strategy for rheumatoid arthritis (RA), was first approved for treatment of RA in Japan in 1999 at the recommended dose of 6-8 mg/week; it was approved as first-line drug with the maximum dose of 16 mg/week in February 2011. However, more than half of Japanese patients with RA are unable to tolerate a dose of 16 mg/week of MTX. Moreover, some serious adverse events during the treatment with MTX, such as pneumocystis pneumonia and lymphoproliferative disorders, have been observed much more frequently in Japan than in other countries...
May 2, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29713747/the-prognostic-value-of-positron-emission-tomography-computed-tomography-in-rheumatoid-arthritis-patients-with-methotrexate-associated-lymphoproliferative-disorders
#4
Satoshi Takanashi, Tomonori Nakazato, Yoshinobu Aisa, Chisako Ito, Hideki Arakaki, Yuki Osada, Motoharu Hirano, Takehiko Mori
Recently, methotrexate-associated lymphoproliferative disorders (MTX-LPDs) in rheumatoid arthritis (RA) have been found to commonly occur in association with iatrogenic immunodeficiency. Several factors have been reported to be related to the prognosis. We herein investigate the efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in predicting the prognosis of MTX-LPD. We performed a retrospective analysis of the clinical features, characteristics, and outcomes of 18 patients with MTX-LPDs who were treated from 2004 to 2015...
April 30, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29676371/methotrexate-associated-epstein-barr-virus-mucocutaneous-ulcer-a-case-report-and-review-of-literature
#5
Priyanka Yogendra Ravi, Elanthenral Sigamani, Yasir Jeelani, Marie Therese Manipadam
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) comprises part of the spectrum of B-cell lymphoproliferative disorders, reported in settings of immunosenescence and iatrogenic immunosuppression, affecting the oropharyngeal mucosa, skin, and gastrointestinal tract. We report a case of a 59-year-old female, known case of rheumatoid arthritis on methotrexate (MTX) for 15 years, who presented with an ulcer in the inner aspect of her cheek region for 2 years. Clinical examination revealed an infiltrative lesion involving the lower gingivobuccal sulcus of size 2 cm × 3 cm extending to the alveolus with level I lymph nodes, suspicious for carcinoma buccal mucosa...
April 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29526961/choledochoduodenal-fistula-during-chemotherapy-with-brentuximab-vedotin-for-methotrexate-associated-lymphoproliferative-disorder
#6
Yuji Eso, Norimitsu Uza, Kotaro Shirakawa, Kenji Sawada, Kentaro Katsuragi, Minoru Matsuura, Hiroshi Seno
We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy...
March 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29491299/adult-t-cell-leukemia-lymphoma-as-a-methotrexate-associated-lymphoproliferative-disorder-in-a-patient-with-rheumatoid-arthritis-a-case-report
#7
Ichiro Takajo, Kunihiko Umekita, Yoshihiko Ikei, Koichi Oshima, Akihiko Okayama
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...
February 28, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29279493/other-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorder-hodgkin-type-following-epstein-barr-viral-hepatitis-in-a-patient-with-rheumatoid-arthritis
#8
Masuho Saburi, Masao Ogata, Natsumi Yoshida, Yuko Nashimoto, Yui Moroga, Kuniko Takano, Kazuhiro Kohno, Tsutomu Daa, Kuniaki Shirao
A 59-year-old man with an 18-year history of rheumatoid arthritis who had been treated with steroids, methotrexate, and infliximab presented with a high-grade fever, cervical lymphadenopathy, and hepatosplenomegaly. Epstein-Barr virus (EBV) hepatitis was diagnosed based on the liver histology and EBV antibody titer. The symptoms improved temporarily, but five months later, the fever, skin rash, jaundice, and thrombocytopenia relapsed. Bone marrow and liver biopsies demonstrated infiltration with Reed-Sternberg cells...
December 27, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29225245/oral-methotrexate-related-lymphoproliferative-disease-presenting-with-severe-osteonecrosis-of-the-jaw-a-case-report-and-literature-review
#9
Sachiko Furukawa, Kazunari Oobu, Masafumi Moriyama, Shintaro Kawano, Saori Sako, Jun-Nosuke Hayashida, Ryota Matsubara, Ken-Ichi Ogata, Tamotsu Kiyoshima, Seiji Nakamura
Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD...
February 15, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29213000/-a-methotrexate-associated-lympholiferative-disorder-patient-with-gastrointestinal-perforation
#10
Yasuo Aota, Tadahito Nonaka, Sei Kimura, Tadahiro Honda, Yuko Okuda, Tsubasa Watanabe, Keitaro Fujiwara, Tomohisa Yokoyama, Yukari Wakabayashi, Michio Sakurai, Akihiko Gotoh
A 70-year-old woman was diagnosed with chronic rheumatoid arthritis and treated with methotrexate and prednisolone. She visited our hospital to determine the cause of her continuous fatigue and fever for the past three weeks. She consumed no food orally and was provided antibiotics because free air was found on computed tomography (CT). Intraperitoneal small lymphadenopathy and swelling of both adrenal glands was also found on CT, and MTX-associated lymphoproliferative disorder (MTX-LPD) was suspected. Am adrenal gland biopsy showed diffuse large B-cell lymphoma (DLBCL) associated with MTX-LPD...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29208331/autoimmune-and-medication-induced-lymphadenopathies
#11
REVIEW
Alejandro A Gru, Dennis P O'Malley
This article will provide a discussion of some common autoimmune disorders that could affect the lymph nodes and potentially mimic B and T-cell lymphomas. Some of these disorders are more characteristic of individuals in the pediatric age group (autoimmune lymphoproliferative syndrome, Kawasaki disease), while others present in older individuals (rheumatoid arthritis, lupus erythematosus, sarcoidosis). A common finding that groups all of these disorders together is the overall relative preservation of the architecture, a feature that can be particularly helpful to distinguish them from many B and T-cell lymphomas...
January 2018: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/29196307/methotrexate-associated-lymphoproliferative-disease-with-multiple-pulmonary-nodules-in-a-patient-with-rheumatoid-arthritis
#12
Wei-Fu Lai, Yen-Po Chin, Chih-Wei Liu, Chang-Youh Tsai
A 62-year-old woman with rheumatoid arthritis and secondary Sjögren's syndrome took methotrexate (MTX) 5 mg three times a week regularly but gradually developed an intermittent fever, oral ulcers and productive cough with mucopurulent sputum for about 2 weeks. Image study found multiple nodular lesions and lymphadenopathies in bilateral lungs. Empirical antibiotics for 1 week failed to alleviate the fever. A transbronchial biopsy in the right fourth bronchus showed infiltration of abnormally enlarged lymphoid cells with a surface marker of CD20, some of which also stained positively in situ with Epstein-Barr virus-encoded small RNA and some CD3(+) cells...
December 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29057700/polymorphic-lymphoproliferative-disorders-in-patients-with-rheumatoid-arthritis-are-associated-with-a-better-clinical-outcome
#13
Daisuke Tsukui, Hiroko Kanda, Aya Shinozaki-Ushiku, Shoko Tateishi, Yusuke Takeshima, Yasuo Nagafuchi, Oh Sasaki, Yukiko Iwasaki, Hiroaki Harada, Mihoko Shibuya, Shuji Sumitomo, Hirofumi Shoda, Kanae Kubo, Keishi Fujio, Fumihiko Nakamura, Mineo Kurokawa, Masashi Fukayama, Kazuhiko Yamamoto
OBJECTIVES: The characteristics of lymphoproliferative disorders (LPD) in patients with rheumatoid arthritis (RA) remain unclear. Therefore, we retrospectively analyzed the clinical characteristics of these patients in our department. METHODS: Twenty RA patients who developed LPD between April 2003 and August 2016 in our department were analyzed. RESULTS: All of the RA patients who developed LPD had been treated with methotrexate (MTX). The median weekly and total dosages of MTX were 6...
October 23, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28878854/composite-cutaneous-lymphoma-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorder-in-a-patient-with-rheumatoid-arthritis-treated-with-methotrexate-staging-and-evaluation-of-response-to-therapy-with-18-f-fdg-pet-ct
#14
William Makis, Anthony Ciarallo, Beatrice Wang, Milene Gonzalez-Verdecia, Stephan Probst
A 67 year old woman with a 10 year history of rheumatoid arthritis (RA) treated with methotrexate and prednisone, presented with a 2 year history of worsening multiple cutaneous plaques of variable appearance. Two distinct skin lesions were biopsied to reveal a composite cutaneous lymphoma, possibly caused by long term methotrexate therapy. An [18F] fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) was performed to stage the malignancy, and was later repeated to evaluate response to chemotherapy, which guided subsequent management...
September 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28758827/lymphoproliferative-disorders-in-patients-with-rheumatoid-arthritis-in-the-era-of-widespread-use-of-methotrexate-a-review-of-the-literature-and-current-perspective
#15
Masayoshi Harigai
Lymphoproliferative disorders (LPD) in patients receiving methotrexate (MTX) have gained strong attention. In this article, I reviewed the basic and clinical findings of this issue. Patients with RA possess a high risk of lymphoma, but epidemiological evidence showing an association between the use of MTX and lymphoma is still limited. Rapid regression of LPD after stopping MTX in patients with RA strongly suggests that there is a causative relationship. Genetic predisposition, accumulated inflammation, impaired generation of Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes, effects of MTX on the regulation of EBV genes, and low hypermethylation of apoptosis-related genes are relevant to the development of LPD and rapid regression after cessation of MTX...
January 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/28747604/methotrexate-associated-lymphoproliferative-disorder
#16
REVIEW
Yuko Kaneko
Methotrexate-associated lymphproliferative disorder (MTX-LPD) is a rare but critical complication developing in patients treated with methotrexate. Now that methotrexate is an anchor drug in the management of rheumatoid arthritis and become commonly used, MTX-LPD cases have increased. Many things has been unclear such as incidence, demographic characters, and risk factors. However, as the researches increased, several interesting topics has been demonstrated like associations with Epsteiin-Barr virus and with cell-mediated immunity...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
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
#17
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
#18
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...
October 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
#19
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...
January 2018: 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
#20
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
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