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

被引：4

作者：

Sakaguchi, Ryuki ^{[1
]}

Fujikawa, Keita ^{[1
]}

Okamoto, Momoko ^{[1
]}

Matsuo, Emi ^{[2
]}

Matsumoto, Kohei ^{[3
]}

Uchida, Tomohisa ^{[1
]}

Shin-ya, Kawashiri ^{[4
]}

Nakashima, Masahiro ^{[5
]}

Mizokami, Akinari ^{[1
]}

Kawakami, Atsushi ^{[4
]}

机构：

[1] Isahaya Gen Hosp, Dept Rheumatol, Japan Community Healthcare Org, Isahaya, Japan

[2] Isahaya Gen Hosp, Dept Hematol, Japan Community Healthcare Org, Isahaya, Japan

[3] Isahaya Gen Hosp, Dept Otolaryngol, Japan Community Healthcare Org, Isahaya, Japan

[4] Nagasaki Univ, Grad Sch Biomed Sci, Dept Immunol & Rheumatol, Nagasaki, Japan

[5] Nagasaki Univ, Atom Bomb Dis Inst, Dept Tumor & Diagnost Pathol, Nagasaki, Japan

来源：

INTERNAL MEDICINE | 2019年 / 58卷 / 21期

关键词：

nasal septum perforation; methotrexate-associated lymphoproliferative disorder; peripheral T-cell lymphoma; rheumatoid arthritis; EPSTEIN-BARR-VIRUS; VASCULITIS; LYMPHOMA; PATIENT;

D O I：

10.2169/internalmedicine.2995-19

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：3167 / 3171

页数：5

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