口底にメトトレキサート関連性リンパ増殖性疾患を発症した1例
Methotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently approved for use in Japan, also shows excellent clinical effectiveness. However, these agents may increase the risk of malignant lymphoma. W...
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| Published in | 日本口腔外科学会雑誌 Vol. 58; no. 11; pp. 623 - 627 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.11.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.58.623 |
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| Abstract | Methotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently approved for use in Japan, also shows excellent clinical effectiveness. However, these agents may increase the risk of malignant lymphoma. We report a case of methotrexate-associated lymphoproliferative disorder （MTX-LPD） after chemotherapy with MTX and TNF antagonists. A 52-year-old woman presented because of pain in the left oral floor with an ulcer in June 2009. The patient had received MTX therapy for RA for 3 years since 2006, as well as TNF antagonists for 2 years from 2007. The diagnosis of‘ diffuse large B-cell lymphoma’ was established by biopsy of the focus. MTX therapy was discontinued on consultation with her doctor, and the ulcer disappeared in 4 months without any further chemotherapy for lymphoma. |
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| AbstractList | Methotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently approved for use in Japan, also shows excellent clinical effectiveness. However, these agents may increase the risk of malignant lymphoma. We report a case of methotrexate-associated lymphoproliferative disorder （MTX-LPD） after chemotherapy with MTX and TNF antagonists. A 52-year-old woman presented because of pain in the left oral floor with an ulcer in June 2009. The patient had received MTX therapy for RA for 3 years since 2006, as well as TNF antagonists for 2 years from 2007. The diagnosis of‘ diffuse large B-cell lymphoma’ was established by biopsy of the focus. MTX therapy was discontinued on consultation with her doctor, and the ulcer disappeared in 4 months without any further chemotherapy for lymphoma. |
| Author | 松田, 光悦 竹川, 政範 近藤, 英司 吉田, 将亜 三代川, 斉之 柴山, 尚大 |
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| References | 6) Bongartz T, Sutton AJ, et al : Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies : systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 295: 2275-2285, 2006. 11) Park SH, Kim CG, et al : Spontaneous regression of EBV-associated diffuse lymphoproliferative disease in a patient with rheumatoid arthritis after discontinuation of etanercept treatment.Rheumatol Int 28: 475-477, 2008. 2) Feldmann M, Steinman L et al : Design of effective immunotherapy for human autoimmunity. Nature 435: 612-619, 2005. 21) 中峯寛和，笠井孝彦，他：近い将来，私たちが遭遇する機会が増すと思われる疾患：MTX関連リンパ増殖疾患．病理と臨床 25: 251-257, 2007. 1) 厚生科学審議会疾病対策部会リウマチ・アレルギー対策委員会：リウマチ・アレルギー委員会報告書．厚生労働省，東京，2008，1-47頁 14) 越智隆弘: 関節リウマチの診療マニュアル（改訂版）診療のマニュアルとEBMに基づく治療ガイドライン．財団法人日本リウマチ財団，東京，2004，847-889頁. 16) Harris NL and Swerdlow SH : World Health Organization Classification of Tumours. Pathology and Genetics, tumours of Hematopoietic and Lymphoid Tissues. IARC Press, Lyon, 2001, p270-271. 12) Hurley MY, George MN, et al : A transient benign lymph node-based proliferation of T-cells simulating non-Hodgkin lymphoma in a patient with psoriasis treated with tumor necrosis factor alpha and CD11a antagonists. Diagn Pathol June 20, 2008. 13) Deng A, Harvey V, et al : Interstitial Granulomatous Dermatitis Associated With the Use of Tumor Necrosis Factor α Inhibitors. Arch Dermatol 142: 198-202, 2006. 15) Ellman MH, Hurwitz H, et al : Lymphoma developing in a patient with rheumatoid arthritis taking low dose weekly methotrexate. J Rheumatol 18: 1741-1743 1991. 8) Smitten AL, Simon TA, et al : A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis. Arthritis Rest her 10: R45, 2008. 24) Lim IG, Betouch J, et al : Remission of lymphoma after drug withdrawal in rheumatoid arthritis. Med J Aust 177: 500-501, 2002. 10) 鈴木康夫，田中千絵，他：近い将来，私たちが遭遇する機会が増すと思われる疾患：(1)メトトレキセート（MTX）関連リンパ増殖疾患．リウマチ科 28:498-506, 2002. 22) Amon W, Farrel PJ, et al : Reactivation of Epstein Barr virus from latency. Rev Med Virol 57: 1016- 1022, 2005. 4) 生島 香，上田孝文，他：慢性関節リウマチ患者における悪性腫瘍の発症－とくにメソトレキサートと悪性リンパ腫発生の関連について－．臨床リウマチ 11: 19-25, 1999 9) Salloum E, Cooper DL, et al : Spontaneous regression of lymphoproliferative disorders in patients treated with methotrexate for rheumatoid arthritis and other rheumatic diseases. J Clin Oncol 14: 1943-1949, 1996. 5) Geborek P, Bladstrom A, et al : Tumor necrosis factor blockers do not increase overall tumor risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas. Ann Rheum Dis 64: 699-703, 2005. 23) Hasserjian RP, Chen S, et al : Immunomodulator agent-related lymphoproliferative disorders. Mod Pathol 22: 1532-1540, 2009. 18) 住田知樹，加藤友美，他：関節リウマチ患者の上顎に発症したメソトレキセート誘発悪性リンパ腫が疑われた1例．日口外誌 55: 463-466, 2009. 7) Abasolo L, Enrique J, et al : Cancer in rheumatoid arthritis : occurrence, mortality, and associated factors in a south European population. Semin Arthritis Rheum 37: 388-397, 2008. 3) Baecklund E, Ekbom A, et al : Disease activity and risk of lymphoma in patients with rheumatoid arthritis : nested case-control study. Br Med J 317: 180-181, 1998. 20) 畑中隆志，澤木佳弘，他：口腔内メトトレキサート関連リンパ増殖性疾患の1例．日口外誌 57: 104-108, 2011. 19) 小池博文，西澤光弘，他：舌潰瘍を契機に診断されたMTX関連リンパ増殖性疾患の1例．日口外誌 56: 266-270, 2010. 25) Baird RD, van Zyl-Smit RN, et al : Spontaneous remission of low-grade B-cellnon-Hodgkin's lymphoma following withdrawal of methotrexate in a patient with rheumatoid arthritis : case report and review of the literature. Br J Haematol 118: 567-568, 2002. 17) Pastor NM, Kilmurray LG, et al : Methotrexateassociated lymphoproliferative disorder presenting as oral ulcers in a patient with rheumatoid arthritis. Actas Dermosifiliogr 100: 142-146, 2009. |
| References_xml | – reference: 13) Deng A, Harvey V, et al : Interstitial Granulomatous Dermatitis Associated With the Use of Tumor Necrosis Factor α Inhibitors. Arch Dermatol 142: 198-202, 2006. – reference: 4) 生島 香，上田孝文，他：慢性関節リウマチ患者における悪性腫瘍の発症－とくにメソトレキサートと悪性リンパ腫発生の関連について－．臨床リウマチ 11: 19-25, 1999． – reference: 25) Baird RD, van Zyl-Smit RN, et al : Spontaneous remission of low-grade B-cellnon-Hodgkin's lymphoma following withdrawal of methotrexate in a patient with rheumatoid arthritis : case report and review of the literature. Br J Haematol 118: 567-568, 2002. – reference: 7) Abasolo L, Enrique J, et al : Cancer in rheumatoid arthritis : occurrence, mortality, and associated factors in a south European population. Semin Arthritis Rheum 37: 388-397, 2008. – reference: 20) 畑中隆志，澤木佳弘，他：口腔内メトトレキサート関連リンパ増殖性疾患の1例．日口外誌 57: 104-108, 2011. – reference: 16) Harris NL and Swerdlow SH : World Health Organization Classification of Tumours. Pathology and Genetics, tumours of Hematopoietic and Lymphoid Tissues. IARC Press, Lyon, 2001, p270-271. – reference: 12) Hurley MY, George MN, et al : A transient benign lymph node-based proliferation of T-cells simulating non-Hodgkin lymphoma in a patient with psoriasis treated with tumor necrosis factor alpha and CD11a antagonists. Diagn Pathol June 20, 2008. – reference: 24) Lim IG, Betouch J, et al : Remission of lymphoma after drug withdrawal in rheumatoid arthritis. Med J Aust 177: 500-501, 2002. – reference: 10) 鈴木康夫，田中千絵，他：近い将来，私たちが遭遇する機会が増すと思われる疾患：(1)メトトレキセート（MTX）関連リンパ増殖疾患．リウマチ科 28:498-506, 2002. – reference: 19) 小池博文，西澤光弘，他：舌潰瘍を契機に診断されたMTX関連リンパ増殖性疾患の1例．日口外誌 56: 266-270, 2010. – reference: 14) 越智隆弘: 関節リウマチの診療マニュアル（改訂版）診療のマニュアルとEBMに基づく治療ガイドライン．財団法人日本リウマチ財団，東京，2004，847-889頁. – reference: 23) Hasserjian RP, Chen S, et al : Immunomodulator agent-related lymphoproliferative disorders. Mod Pathol 22: 1532-1540, 2009. – reference: 6) Bongartz T, Sutton AJ, et al : Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies : systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 295: 2275-2285, 2006. – reference: 5) Geborek P, Bladstrom A, et al : Tumor necrosis factor blockers do not increase overall tumor risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas. Ann Rheum Dis 64: 699-703, 2005. – reference: 9) Salloum E, Cooper DL, et al : Spontaneous regression of lymphoproliferative disorders in patients treated with methotrexate for rheumatoid arthritis and other rheumatic diseases. J Clin Oncol 14: 1943-1949, 1996. – reference: 2) Feldmann M, Steinman L et al : Design of effective immunotherapy for human autoimmunity. Nature 435: 612-619, 2005. – reference: 3) Baecklund E, Ekbom A, et al : Disease activity and risk of lymphoma in patients with rheumatoid arthritis : nested case-control study. Br Med J 317: 180-181, 1998. – reference: 22) Amon W, Farrel PJ, et al : Reactivation of Epstein Barr virus from latency. Rev Med Virol 57: 1016- 1022, 2005. – reference: 8) Smitten AL, Simon TA, et al : A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis. Arthritis Rest her 10: R45, 2008. – reference: 17) Pastor NM, Kilmurray LG, et al : Methotrexateassociated lymphoproliferative disorder presenting as oral ulcers in a patient with rheumatoid arthritis. Actas Dermosifiliogr 100: 142-146, 2009. – reference: 18) 住田知樹，加藤友美，他：関節リウマチ患者の上顎に発症したメソトレキセート誘発悪性リンパ腫が疑われた1例．日口外誌 55: 463-466, 2009. – reference: 15) Ellman MH, Hurwitz H, et al : Lymphoma developing in a patient with rheumatoid arthritis taking low dose weekly methotrexate. J Rheumatol 18: 1741-1743 1991. – reference: 1) 厚生科学審議会疾病対策部会リウマチ・アレルギー対策委員会：リウマチ・アレルギー委員会報告書．厚生労働省，東京，2008，1-47頁． – reference: 21) 中峯寛和，笠井孝彦，他：近い将来，私たちが遭遇する機会が増すと思われる疾患：MTX関連リンパ増殖疾患．病理と臨床 25: 251-257, 2007. – reference: 11) Park SH, Kim CG, et al : Spontaneous regression of EBV-associated diffuse lymphoproliferative disease in a patient with rheumatoid arthritis after discontinuation of etanercept treatment.Rheumatol Int 28: 475-477, 2008. |
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| Snippet | Methotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently... |
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| SubjectTerms | メトトレキサート関連性リンパ増殖性疾患 腫瘍壊死因子 関節リウマチ |
| Title | 口底にメトトレキサート関連性リンパ増殖性疾患を発症した1例 |
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