Methotrexate-associated lymphoproliferative disease with multiple pulmonary nodules in a patient with rheumatoid arthritis.
BMJ Case Rep
; 20172017 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-29196307
ABSTRACT
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. After a diagnosis of MTX-associated lymphoproliferative disease had been made, MTX was discontinued immediately and intravenous methylprednisolone 125 mg/day was given for 1 week. The clinical condition improved dramatically within 1 month and there was no recurrence after 3-year follow-up.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
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Síndrome de Sjogren
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Metotrexato
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Nódulos Pulmonares Múltiplos
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Transtornos Linfoproliferativos
Tipo de estudo:
Risk_factors_studies
Limite:
Female
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Humans
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Middle aged
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2017
Tipo de documento:
Article