title: Epstein-Barr virus associated Hodgkin lymphoma in a 9-year-old girl receiving long-term methotrexate therapy for juvenile idiopathic arthritis.
abstract: We describe a case of Hodgkin lymphoma developing in a 9-year-old girl with polyarticular, rheumatoid factor-positive juvenile idiopathic arthritis treated with methotrexate (MTX), prednisone, and naproxen for 5 years. Pathologic and molecular analyses revealed that the Hodgkin cells contained Epstein-Barr virus and the viral DNA was monoclonal. She achieved complete remission after MTX withdrawal, chemotherapy, and radiation. To the best of my knowledge, this is the sixth report of Hodgkin lymphoma in patients with juvenile idiopathic arthritis receiving low dose MTX therapy.
authors.affiliation: Department of Pathology, Miyagi Children's Hospital, Sendai, Japan. jtakeyama@miyagi-children.or.jp
authors.forename: Junji
authors.initials: J
authors.lastname: Takeyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sato
authors.forename: Kyoko
authors.initials: K
authors.lastname: Nakano
authors.forename: Daiki
authors.initials: D
authors.lastname: Abukawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Ichinohazama
authors.forename: Masue
authors.initials: M
authors.lastname: Imaizumi
mesh_terms: D001171:Arthritis, Juvenile / Q000188:drug therapy; D002648:Child; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D004854:Herpesvirus 4, Human; D006689:Hodgkin Disease / Q000139:chemically induced* / Q000382:microbiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008727:Methotrexate / Q000009:adverse effects*; D009288:Naproxen / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors; D014412:Tumor Virus Infections / Q000150:complications*
chemical_list: D007166:Immunosuppressive Agents; D009288:Naproxen; D011241:Prednisone; D008727:Methotrexate