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Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis


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Title: Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis
Authors: Toyama, Shiho / Takatani, Ayuko / Koga, Tomohiro / Eguchi, Mizuna / Okamoto, Momoko / Tsuji, Sosuke / Endo, Yushiro / Shimizu, Toshimasa / Sumiyoshi, Remi / Igawa, Takashi / Kawashiri, Shin-ya / Iwamoto, Naoki / Ichinose, Kunihiro / Tamai, Mami / Nakamura, Hideki / Origuchi, Tomoki / Furuyama, Masako / Tabuchi, Maiko / Kobayashi, Shinichiro / Kanetaka, Kengo / Hashisako, Mikiko / Abe, Kuniko / Niino, Daisuke / Sato, Shinya / Miyazaki, Yasushi / Kawakami, Atsushi
Issue Date: 15-Nov-2019
Publisher: 日本内科学会 / Japanese Society of Internal Medicine
Citation: Internal Medicine, 58(22), pp.3331-3336; 2019
Abstract: A 71-year-old woman being treated with methotrexate (MTX) and tacrolimus (TAC) for rheumatoid arthritis (RA) was admitted to our hospital and underwent surgery for gastric perforation and peritonitis. An endoscopic examination six days post-surgery showed an extensive ulcer in the stomach, and a biopsy revealed diffused large B-cell lymphoma. We diagnosed her with immunodeficiency-associated lymphoproliferative disorder (LPD) and discontinued the MTX and TAC. She underwent gastrectomy due to stenosis approximately two months after the first operation, but the histopathological findings of lymphoma had disappeared. LPD should be considered as a potential cause of gastric perforation during RA treatment. © 2019 Japanese Society of Internal Medicine.
Keywords: gastric perforation / iatrogenic immunodeficiency-associated lymphoproliferative disorder / methotrexate / tacrolimus / rheumatoid arthritis
URI: http://hdl.handle.net/10069/39559
ISSN: 09182918
DOI: 10.2169/internalmedicine.2782-19
Rights: © 2019 by The Japanese Society of Internal Medicine. The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/39559

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