Rheumatoid Arthritis Complicated with Nasal Septum Perforation Due to Methotrexate-associated Lymphoproliferative Disorder.


Journal

Internal medicine (Tokyo, Japan)
ISSN: 1349-7235
Titre abrégé: Intern Med
Pays: Japan
ID NLM: 9204241

Informations de publication

Date de publication:
01 Nov 2019
Historique:
pubmed: 12 7 2019
medline: 12 2 2020
entrez: 12 7 2019
Statut: ppublish

Résumé

A 44-year-old female with rheumatoid arthritis treated with methotrexate (MTX) and tocilizumab (TCZ) was admitted to our hospital with nasal pain. Nasal fiberscopy revealed septum perforation, while a membrane biopsy indicated granuloma and fibrinoid necrosis of the small artery. The patient was treated with prednisolone 30 mg/day after discontinuation of MTX and TCZ. Inguinal lymph node biopsy revealed diffuse infiltrations of atypical T-cells and Epstein-Barr virus-positive B cells. The patient was diagnosed with peripheral T-cell lymphoma due to MTX-associated lymphoproliferative disorder (MTX-LPD). We herein describe the case of a patient with nasal septum perforation due to MTX-LPD mimicking granulomatosis with polyangiitis.

Identifiants

pubmed: 31292392
doi: 10.2169/internalmedicine.2995-19
pmc: PMC6875446
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Antirheumatic Agents 0
tocilizumab I031V2H011
Methotrexate YL5FZ2Y5U1

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3167-3171

Références

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Auteurs

Ryuki Sakaguchi (R)

Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Keita Fujikawa (K)

Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Momoko Okamoto (M)

Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Emi Matsuo (E)

Department of Hematology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Kohei Matsumoto (K)

Department of Otolaryngology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Tomohisa Uchida (T)

Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Kawashiri Shin-Ya (K)

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan.

Masahiro Nakashima (M)

Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Japan.

Akinari Mizokami (A)

Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Japan.

Atsushi Kawakami (A)

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan.

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Classifications MeSH