title: [Splenic marginal zone lymphoma associated with antiphospholipid antibodies].
abstract: A 61-year-old woman experienced a high fever with anemia and APTT prolongation after suffering a herpes zoster virus infection. Physical examination revealed a large splenomegaly without lymphadenopathy. Laboratory evaluations were positive for lupus anticoagulant (LA) and monoclonal IgM-kappa protein. LA was associated with the presence of anti-beta2GPI antibody, anti-cardiolipin antibody, and anti-prothrombin antibody. Moreover, the results of factors IX, XI, and XII assays and CRP and FDP-E were disturbed. A splenectomy was performed, and a splenic marginal zone lymphoma (SMZL) was diagnosed. All hematological findings rapidly recovered after the splenectomy. No thrombotic events occurred after the splenectomy even though thrombosis prophylaxis was not performed. The clinical course suggested that the SMZL-producing antibody induced immunological abnormalities in the labolatory tests. Since the patient suffered disease progression soon after the splenectomy, an autologous peripheral stem cell transplantation with rituximab administration was performed.
authors.affiliation: First Department of Internal Medicine, Kansai Medical University.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Komiyama
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Uemura
authors.forename: Riki
authors.initials: R
authors.lastname: Tanijiri
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Nakai
authors.forename: Noriaki
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Zen
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Amakawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ieko
authors.forename: Hakuo
authors.initials: H
authors.lastname: Takahashi
authors.forename: Shirou
authors.initials: S
authors.lastname: Fukuhara
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D000069283:Rituximab; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D016682:Lupus Coagulation Inhibitor; D000069283:Rituximab