Abstract | BACKGROUND: CASE PRESENTATION: A Japanese female patient of between 60 and 70 years of age with rheumatoid arthritis was admitted to our hospital because of sudden convulsion and impaired consciousness. Just before admission, she was treated with adalimumab and methotrexate. Contrast-enhanced computed tomography scan showed a densely stained mass with surrounding edema in both frontal lobes and the left nucleus basalis, and enlarged lymph nodes in the right supraclavicular fossa. We performed a biopsy of the right cervical lymph node, but could not establish a histopathological diagnosis. In situ hybridization showed the presence of Epstein Barr virus, therefore we diagnosed this case as methotrexate-associated lymphoproliferative disorders mediated by Epstein Barr virus after considering the drug history of the patient. After we discontinued methotrexate, patient symptoms gradually improved. The masses at both frontal lobes and the left nucleus basalis were gradually regressed. CONCLUSION:
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Authors | Hiromi Shimada, Hiroaki Dobashi, Hisanori Morimoto, Tomohiro Kameda, Kentaro Susaki, Miharu Izumikawa, Yohei Takeuchi, Shusaku Nakashima, Osamu Imataki, Shuji Bandoh |
Journal | BMC research notes
(BMC Res Notes)
Vol. 8
Pg. 88
(Mar 19 2015)
ISSN: 1756-0500 [Electronic] England |
PMID | 25888766
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antirheumatic Agents
- Methotrexate
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Topics |
- Aged
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(drug therapy)
- Central Nervous System Neoplasms
(complications, diagnosis, diagnostic imaging)
- Female
- Humans
- Lymphoma, Non-Hodgkin
(complications, diagnosis, diagnostic imaging)
- Methotrexate
(therapeutic use)
- Middle Aged
- Tomography, X-Ray Computed
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