CD8(+) T-cell lymphoproliferative disorder associated with Epstein-Barr virus in a patient with rheumatoid arthritis during methotrexate therapy.
A 75-year-old woman with rheumatoid arthritis (RA) who was receiving methotrexate (MTX) therapy developed Epstein-Barr virus (EBV)-associated CD8(+) T-cell lymphoproliferative disorder (LPD) and meningoencephalitis. She was successfully treated with acyclovir and corticosteroids plus MTX cessation. T-cell LPD is relatively rare in RA patients receiving MTX. To our knowledge, this is the first report of CD8(+) T-cell LPD with EBV genome occurring during MTX therapy for RA. EBV infection should be carefully monitored to assess severe EBV-associated complications.
Hatachi
Saori
S
Division of Clinical Immunology and Rheumatology, Department of Medicine, Kitano Hospital, 2-4-20 Ogimachi, Kita-Ku, Osaka 530-8480, Japan. sa-hatati@kitano-hp.or.jp
Kunitomi
Akane
A
Aozasa
Katsuyuki
K
Yagita
Masato
M
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor / Q000235:genetics; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D016130:Immunophenotyping; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D008590:Meningoencephalitis / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D008727:Methotrexate / Q000009:adverse effects*; D008775:Methylprednisolone / Q000627:therapeutic use
D018501:Antirheumatic Agents; D000998:Antiviral Agents; D000212:Acyclovir; D008775:Methylprednisolone; D008727:Methotrexate