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Hepatic methotrexate-associated lymphoproliferative disorders identified by multiple liver tumors: a case report and review of the literature.

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  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: [London] : BioMed Central, [2007-
    • الموضوع:
      Antirheumatic Agents/*adverse effects ; Chemical and Drug Induced Liver Injury/*etiology ; Lymphoproliferative Disorders/*chemically induced ; Lymphoproliferative Disorders/*diagnosis ; Methotrexate/*adverse effects; Aged, 80 and over ; Arthritis, Rheumatoid/drug therapy ; Chemical and Drug Induced Liver Injury/diagnostic imaging ; Humans ; Male
    • نبذة مختصرة :
      Background: Methotrexate, an immunosuppressant, is widely used as the standard therapeutic drug for rheumatoid arthritis. With the increasing frequency of use of methotrexate, adverse effects of methotrexate have been reported, one of which is known as methotrexate-associated lymphoproliferative disorders. The etiology of hepatic methotrexate-associated lymphoproliferative disorders remains largely unknown. To date, there have only been ten cases of hepatic methotrexate-associated lymphoproliferative disorders reported in the English literature and a case report is very rare.
      Case Presentation: An 82-year-old Japanese man with rheumatoid arthritis treated with methotrexate presented with fever. Contrast-enhanced computed tomography showed multiple hypovascular nodules in his liver, spleen, and lung, and para-aortic lesions. Endoscopic ultrasound-guided fine-needle aspiration biopsy for liver tumors was performed, and pathological results identified cluster of differentiation 20-positive lymphocytes. Discontinuance of methotrexate led to regression of the nodules and a final definitive diagnosis of methotrexate-associated lymphoproliferative disorders was made.
      Conclusions: We review 11 reported cases of hepatic methotrexate-associated lymphoproliferative disorders including the present case. Physicians should discontinue methotrexate in patients with rheumatoid arthritis treated with methotrexate when elevated soluble interleukin-2 receptor and hypovascular lesions in contrast-enhanced computed tomography are confirmed considering the possibility of methotrexate-associated lymphoproliferative disorders.
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    • Contributed Indexing:
      Keywords: Fever; Liver tumor; MTX-LPD; Methotrexate-associated lymphoproliferative disorders; Rheumatoid arthritis
    • الرقم المعرف:
      0 (Antirheumatic Agents)
      YL5FZ2Y5U1 (Methotrexate)
    • الموضوع:
      Date Created: 20190628 Date Completed: 20200115 Latest Revision: 20200225
    • الموضوع:
      20240829
    • الرقم المعرف:
      PMC6595583
    • الرقم المعرف:
      10.1186/s13256-019-2135-3
    • الرقم المعرف:
      31242930