Anaplastic large cell lymphoma in a patient with systemic onset juvenile arthritis: case report and review of literature.
The association of malignancy with autoimmune rheumatic diseases has been a subject of investigation. It has been shown that there is increased risk of malignancies, mainly non-Hodgkin lymphoma, in patients with autoimmune disorders. There is scarcity of data about malignancy in juvenile idiopathic arthritis (JIA). We report the occurrence of anaplastic large cell lymphoma in a patient with systemic onset juvenile idiopathic arthritis treated with low dose methotrexate (MTX). A relationship between MTX treatment and the occurrence of lymphoma in autoimmune diseases has been suggested. The hypothesis that MTX has a role in the aetiology of lymphoproliferative disorders is supported by the observation of spontaneous remission of lymphoma in few cases on cessation of MTX therapy. However, systemic onset juvenile idiopathic arthritis patients receiving MTX must be periodically examined for the development of lymphoproliferative disorder especially if the disease is difficult to control or patient develop new symptoms on therapy.
Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Bharat K
BK
Singh
Paul T
PT
Antony
Surendra K
SK
Verma
Debdutta
D
Basu
Vir S
VS
Negi
D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy*; D001706:Biopsy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017728:Lymphoma, Large-Cell, Anaplastic / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D007166:Immunosuppressive Agents; D008727:Methotrexate
anaplastic large cell lymphoma ALK negative; methotrexate; systemic onset juvenile idiopathic arthritis