[Four Cases of Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorders in the Head and Neck Region].

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. In two cases (one case MTX and another case tacrolimus) drug therapy was discontinued, when the patients were diagnosed as having OIIA-LPD in only a few local findings. These patients have followed good clinical courses for 24 months. In the other two cases, consultations were performed for cervical lymphadenopathy by the Division of Rheumatology. In one case drug therapy was discontinued and a good clinical course was followed. In case of the other patient, however, who had undergone tacrolimus therapy after MTX therapy was discontinued, she relapsed and died. In the case of patients with an autoimmune disease such as RA who are taking MTX, tacrolimus, or anti TNF-α therapy, when cervical lymphadenopathy and extranodal disease are detected, OIIA-LPD should be suspected. We should cooperate with a hematologist-oncologist, a rheumatologist, and pathologist in such a case.

[Clinical effect of bipolar radiofrequency thermotherapy on allergic rhinitis].

The clinical effect of bipolar radiofrequency thermotherapy on allergic rhinitis was evaluated. A bipolar radiofrequency system (CelonLab ENT) was used on 16 patients suffering from allergic rhinitis from February 2003 and August 2003. The thermotherapy was conducted under local anesthesia and data was collected by preoperative questionnaire and rhinomanometry and 2 months and 2 years postoperatively. Nearly all the patients reported relieved nasal patency, rhinorrhea, and sneezeing. Statistically significant improvements were observed for all the measured VAS scores: nasal patency, rhinorrhea, and sneezeing. Nasal resistance measured by anterior rhinomanometry also significantly improved. We concluded that CelonLab ENT is effective and safe in treating allergic rhinitis.

Effect of fexofenadine hydrochloride on cedar pollinosis.

OBJECTIVE: To investigate the therapeutic efficacy of fexofenadine hydrochloride (Allegra(R) tablets), an antihistaminic launched in 2001, in patients with cedar pollinosis by dividing them into two groups for comparison, i.e. the early-treatment group in which treatment was started before the initial day of the pollen scattering, and the therapeutic-treatment group in which treatment was started after the initial day of the pollen scattering. METHODS: Early-treatment group: patients who visited the hospital before the initial day of cedar pollen scattering were orally given one tablet of the drug twice daily. Therapeutic-treatment group: patients who visited the hospital after the initial day of cedar pollen scattering were orally given one tablet of the drug twice daily. The total number of cases in which the efficacy evaluation was possible was 37 cases (19 cases of the early-treatment group and 18 cases of the therapeutic-treatment group) after application of exclusion criteria. RESULTS: The useful rate of moderately effective or better against sneeze was 90% in the early-treatment group, and 78% in the therapeutic-treatment group, and there was a significant difference between both groups. The degree of satisfaction in the early-treatment group was 3.8 points, and 4.2 points in the therapeutic-treatment group, and the therapeutic-treatment group showed a higher score, but there was no significant difference between both groups. As adverse reaction, there was only one case of mild dizziness (2.7%), and no other adverse reactions such as sleepiness were observed. CONCLUSIONS: It was suggested that fexofenadine hydrochloride administered in patients with cedar pollinosis from before substantial pollen scattering might control their symptoms to mild ones, and might control worsening of their symptoms after the substantial pollen scattering, and, therefore, the drug was considered to be useful in early therapy.