Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis: A Very Rare Case

Internal Medicine
Masao HagiharaMorihiro Inoue

Abstract

We herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL. The patient received a rituximab-containing chemotherapy and achieved complete remission.

References

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Citations

May 20, 2020·International Journal of Molecular Sciences·Przemysław KoźmińskiEwa Gniazdowska
Jul 2, 2019·Journal of Clinical and Experimental Hematopathology : JCEH·Michihide TokuhiraMasahiro Kizaki
Aug 23, 2021·Annals of Hematology·Hiroaki NagataJunya Kuroda

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Methods Mentioned

BETA
biopsies
biopsy

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