Excessive hepatitis-B surface antigen production after corticosteroids and the development of immunoblastic lymphoma.
The development of B-cell immunoblastic lymphoma in a 51 year old patient with hepatitis B virus related immune complex nephritis is described. The lymphoma was diagnosed eleven months after the administration of high dose corticosteroids which resulted in a striking increase in the HBsAg serum titer up to 1:1,000,000. This unusual association raises a number of interesting questions regarding the link between immune complex nephritis and immunoblastic lymphoma. The significance of corticosteroid therapy leading to excessive HBsAg secretion and the role played by this intense antigenic stimulation in the pathogenesis of lymphoma in this particular patient are also discussed.
Ras
E
E
Department of Medicine, Mount Scopus, Jerusalem, Israel.
Michaeli
J
J
Rosenmann
E
E
Popovtzer
M M
MM
Polliack
A
A
Shouval
D
D
D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D015967:Gene Expression Regulation, Viral / Q000187:drug effects; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000209:etiology*; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000096:biosynthesis*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology / Q000502:physiology; D006801:Humans; D007105:Immune Complex Diseases / Q000209:etiology*; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000473:pathology; D008775:Methylprednisolone / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000150:complications* / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000473:pathology; D011241:Prednisone / Q000494:pharmacology* / Q000627:therapeutic use; D014775:Virus Activation / Q000187:drug effects*
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D011241:Prednisone; D008775:Methylprednisolone