Epstein-Barr virus associated Hodgkin lymphoma in a 9-year-old girl receiving long-term methotrexate therapy for juvenile idiopathic arthritis.
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.
Takeyama
Junji
J
Department of Pathology, Miyagi Children's Hospital, Sendai, Japan. jtakeyama@miyagi-children.or.jp
Sato
Atsushi
A
Nakano
Kyoko
K
Abukawa
Daiki
D
Ichinohazama
Ryo
R
Imaizumi
Masue
M
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*
D007166:Immunosuppressive Agents; D009288:Naproxen; D011241:Prednisone; D008727:Methotrexate