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一名长期血清阳性类风湿关节炎患者在使用甲氨蝶呤治疗期间发生胫骨弥漫性大B细胞淋巴瘤。

Diffuse Large B-cell Lymphoma of the Tibia in a Patient With Longstanding Seropositive Rheumatoid Arthritis on Methotrexate.

作者信息

Oberoi Mansi, Perinkulam Sathyanarayanan Swaminathan, Akther Jacky, Tantoush Hamza

机构信息

Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, USA.

Pathology, University of South Dakota Sanford School of Medicine, Sioux Falls, USA.

出版信息

Cureus. 2022 Mar 16;14(3):e23232. doi: 10.7759/cureus.23232. eCollection 2022 Mar.

DOI:10.7759/cureus.23232
PMID:35449681
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9012651/
Abstract

There has been an observance of increased occurrence of malignant lymphomas in patients with rheumatoid arthritis (RA). The increased risk of lymphoproliferative disorders has been linked to the severity of RA disease activity, the use of disease-modifying agents like methotrexate and certain genetic links between RA and lymphomas. This article outlines the case of an 88-year-old gentleman with a 13-year history of seropositive rheumatoid arthritis on methotrexate who presented with ankle pain and was subsequently found to have diffuse large B-cell lymphoma on further workup.

摘要

类风湿关节炎(RA)患者中恶性淋巴瘤的发生率有所增加。淋巴增殖性疾病风险的增加与RA疾病活动的严重程度、甲氨蝶呤等改善病情药物的使用以及RA与淋巴瘤之间的某些基因联系有关。本文概述了一名88岁男性的病例,他有13年血清阳性类风湿关节炎病史,正在接受甲氨蝶呤治疗,因踝关节疼痛就诊,进一步检查后发现患有弥漫性大B细胞淋巴瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/cb94aa90226c/cureus-0014-00000023232-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/f472639e9fa1/cureus-0014-00000023232-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/839f60f5cb90/cureus-0014-00000023232-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/cb94aa90226c/cureus-0014-00000023232-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/f472639e9fa1/cureus-0014-00000023232-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/839f60f5cb90/cureus-0014-00000023232-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bebc/9012651/cb94aa90226c/cureus-0014-00000023232-i03.jpg

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Diffuse Large B-cell Lymphoma of the Tibia in a Patient With Longstanding Seropositive Rheumatoid Arthritis on Methotrexate.一名长期血清阳性类风湿关节炎患者在使用甲氨蝶呤治疗期间发生胫骨弥漫性大B细胞淋巴瘤。
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本文引用的文献

1
Malignancy and rheumatoid arthritis: Epidemiology, risk factors and management.恶性肿瘤与类风湿关节炎:流行病学、风险因素与管理。
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Genetic overlap between autoimmune diseases and non-Hodgkin lymphoma subtypes.自身免疫性疾病与非霍奇金淋巴瘤亚型之间的遗传重叠。
Genet Epidemiol. 2019 Oct;43(7):844-863. doi: 10.1002/gepi.22242. Epub 2019 Aug 13.
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Methotrexate-associated Lymphoproliferative Disorders in Patients With Rheumatoid Arthritis: Clinicopathologic Features and Prognostic Factors.
类风湿关节炎患者甲氨蝶呤相关淋巴增生性疾病:临床病理特征和预后因素。
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Rheumatoid arthritis and lymphoma: Incidence, pathogenesis, biology, and outcome.类风湿关节炎与淋巴瘤:发病情况、发病机制、生物学特性及转归。
Hematol Oncol. 2018 Dec;36(5):733-739. doi: 10.1002/hon.2525. Epub 2018 Jun 3.
5
Anti-cyclic citrullinated peptide antibodies, other common autoantibodies, and smoking as risk factors for lymphoma in patients with rheumatoid arthritis.抗环瓜氨酸肽抗体、其他常见自身抗体及吸烟作为类风湿关节炎患者淋巴瘤的危险因素
Scand J Rheumatol. 2018 Jul;47(4):270-275. doi: 10.1080/03009742.2017.1376108. Epub 2018 Jan 16.
6
Malignancy Incidence, Management, and Prevention in Patients with Rheumatoid Arthritis.类风湿关节炎患者的恶性肿瘤发病率、管理与预防
Rheumatol Ther. 2017 Dec;4(2):333-347. doi: 10.1007/s40744-017-0064-4. Epub 2017 May 15.
7
Rheumatoid Arthritis and Risk of Malignant Lymphoma: Is the Risk Still Increased?类风湿关节炎与恶性淋巴瘤风险:风险仍增加吗?
Arthritis Rheumatol. 2017 Apr;69(4):700-708. doi: 10.1002/art.40017.
8
Comorbidity in rheumatoid arthritis.类风湿关节炎中的合并症
Swiss Med Wkly. 2016 Apr 5;146:w14290. doi: 10.4414/smw.2016.14290. eCollection 2016.
9
Incidence of malignancy in adult patients with rheumatoid arthritis: a meta-analysis.成年类风湿关节炎患者的恶性肿瘤发病率:一项Meta分析
Arthritis Res Ther. 2015 Aug 15;17(1):212. doi: 10.1186/s13075-015-0728-9.
10
Methotrexate/iatrogenic lymphoproliferative disorders in rheumatoid arthritis: histology, Epstein-Barr virus, and clonality are important predictors of disease progression and regression.甲氨蝶呤/医源性淋巴增生性疾病在类风湿关节炎中的作用:组织学、EB 病毒和克隆性是疾病进展和消退的重要预测因子。
Eur J Haematol. 2013 Jul;91(1):20-8. doi: 10.1111/ejh.12116. Epub 2013 May 13.