RESUMEN
We herein report a case of methotrexate-associated lymphoproliferative disorder (MTX-LPD) showing fibrin-associated large B-cell lymphoma-like heart valve lesions, and Epstein-Barr virus (EBV)-positive mucocutaneous ulcer-like cutaneous and oral mucosal lesions. MTX-LPD is a critical complication that can occur in RA patients who are treated with MTX. EBV also plays a defining or important role in LPDs. Among the sites of MTX-LPD, 40-50% occur in extranodal sites, including the gastrointestinal tract, skin, liver, lung, and kidney. There are few reports of MTX-LPDs involving the heart valves, and to the best of our knowledge, this is the first case to be reported in the English literature. The possibility of EBV-positive LPD should be considered in RA patients, even in patients with an atypical site, as in this case.
Asunto(s)
Válvula Aórtica , Artritis Reumatoide , Linfoma de Células B Grandes Difuso , Trastornos Linfoproliferativos , Metotrexato , Válvula Mitral , Humanos , Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Trastornos Linfoproliferativos/patología , Trastornos Linfoproliferativos/diagnóstico , Trastornos Linfoproliferativos/inducido químicamente , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/diagnóstico , Válvula Mitral/patología , Metotrexato/efectos adversos , Metotrexato/uso terapéutico , Válvula Aórtica/patología , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/patología , Fibrina/metabolismo , Femenino , Anciano , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , MasculinoRESUMEN
In forensic DNA testing, the number of tested short tandem repeat loci has increased owing to new multiplex kits with additional loci. Although this advancement provides improved discrimination power, the effects of linkage and mutation must be considered during kinship analysis. However, no software currently includes both of these effects. In this study, we developed new freeware called KinBN for kinship analysis based on a Bayesian network. The software is graphical-user-interface-based and calculates the likelihood ratios (LRs) at multiple loci considering the effects of linkage and mutation. In addition, the software can simulate the LR distribution according to the specified relationship. We confirmed the accuracy of KinBN by comparing its LRs with those of other software and evaluated the effects of linkage and mutation on the LRs. Our results indicate that KinBN is a useful tool for kinship analysis, particularly if expanded locus sets are used for DNA testing.
