title: Multiple Intestinal Ulcers Associated with Primary Epstein-Barr Virus Infection in a Patient with Rheumatoid Arthritis Undergoing Methotrexate Therapy.
abstract: A 47-year-old woman with a 2-year history of rheumatoid arthritis (RA) undergoing methotrexate treatment developed a perforated ulcer in the ileum for which she underwent emergency surgery. A histological analysis of the extirpated specimen presented a possible Epstein-Barr virus (EBV) infection in the ulcerative lesion without a feature of lymphoproliferative disorder. Interestingly, the patient's serological tests with a paired serum diagnosed a primary EBV infection. The present case emphasizes the importance of being aware of severe enteritis as a possibility for patients with RA, for an accurate diagnosis.
authors.affiliation: Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Makino
authors.forename: Chikayoshi
authors.initials: C
authors.lastname: Tani
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyokawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Yoshimoto
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Mizumoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Eguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujishiro
authors.forename: Satoru
authors.initials: S
authors.lastname: Kodama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Keiji
authors.initials: K
authors.lastname: Komura
authors.forename: Kensaku
authors.initials: K
authors.lastname: Okamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Haneda
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D007077:Ileal Diseases / Q000473:pathology / Q000601:surgery / Q000821:virology*; D007082:Ileum / Q000473:pathology*; D016867:Immunocompromised Host; D007410:Intestinal Diseases / Q000188:drug therapy; D007413:Intestinal Mucosa / Q000821:virology; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D014456:Ulcer / Q000473:pathology / Q000601:surgery / Q000821:virology*
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate