A 62-year-old woman with rheumatoid arthritis and secondary Sjogren's syndrome took methotrexate (MTX) 5 mg three times a week regularly but gradually developed an intermittent fever, oral ulcers and productive cough with mucopurulent sputum for about 2 weeks. Image study found multiple nodular lesions and lymphadenopathies in bilateral lungs. Empirical antibiotics for 1 week failed to alleviate the fever. A transbronchial biopsy in the right fourth bronchus showed infiltration of abnormally enlarged lymphoid cells with a surface marker of CD20, some of which also stained positively in situ with Epstein-Barr virus-encoded small RNA and some CD3(+) cells. After a diagnosis of MTX-associated lymphoproliferative disease had been made, MTX was discontinued immediately and intravenous methylprednisolone 125 mg/day was given for 1 week. The clinical condition improved dramatically within 1 month and there was no recurrence after 3-year follow-up.
No clinical trial protocols linked to this paper
Clinical trials are automatically linked when NCT numbers are found in the paper's title or abstract.PICO Elements
No PICO elements extracted yet. Click "Extract PICO" to analyze this paper.
Paper Details
MeSH Terms
Associated Data
No associated datasets or code repositories found for this paper.
Related Papers
Related paper suggestions will be available in future updates.