Epstein-barr virus-associated Hodgkin's lymphoma and legionella pneumophila infection complicating treatment of juvenile rheumatoid arthritis with methotrexate and cyclosporine A

doi:10.1016/S0046-8177(00)80230-0

Human Pathology

Volume 31, Issue 2, February 2000, Pages 253-255

https://doi.org/10.1016/S0046-8177(00)80230-0 Get rights and content

We describe the case of a 53-month-old girl with juvenile rheumatoid arthritis (JRA), complicated by the occurrence of Hodgkin's lymphoma and Legionella pneumophila infection during immunosuppressive treatment with methotrexate (MTX) and cyclosporine A (CSA). The girl had received variable anti-inflammatory combination therapy, including MTX for 28 months and CSA for 3 months. Thirty-six months after the onset of arthritis, the girl presented with an enlargement of the lymph nodes of the mediastinum, the hilum of the lungs, and the abdomen. Concomitantly, a diagnosis of Legionella pneumonia was rendered. Autopsy showed Epstein-Barr virus (EBV)-associated nodular sclerosing Hodgkin's lymphoma. The neoplastic cells were positive for CD15, CD 30, and latent membrane protein 1 (LMP 1). The present case is the second reported to occur in a child, and it lends support to the hypothesis that immunosuppressive treatment may contribute to an increased risk of the development of EBV-associated lymphoproliferative disorders (LPD) in pediatric patients suffering from JRA.

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Case StudyEpstein-barr virus-associated Hodgkin's lymphoma and legionella pneumophila infection complicating treatment of juvenile rheumatoid arthritis with methotrexate and cyclosporine A

Lancet

Am J Med

Hum Pathol

Semin Arthritis Rheum

Combination therapy of cyclosporine with MTX and gold in RA: two pilot studies

J Rheumatol

Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS): The New York University Medical Center experience with 105 patients (1981–1986)

Ann Intern Med

The risk of cancer in rheumatoid patients in Japan

Scand J Rheumatol

Case Study
Epstein-barr virus-associated Hodgkin's lymphoma and legionella pneumophila infection complicating treatment of juvenile rheumatoid arthritis with methotrexate and cyclosporine A