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
收藏
页码：3167 / 3171
页数：5
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