Self-resolution of Epstein-Barr virus-associated B-cell lymphoma in a patient with dermatomyositis following withdrawal of mycophenolate mofetil and methotrexate
Self-resolution of Epstein-Barr virus-associated B-cell lymphoma in a patient with dermatomyositis following withdrawal of mycophenolate mofetil and methotrexate
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DOI：
10.1016/j.jaad.2004.03.020
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发表时间：
2004-08-01
影响因子：
13.8
通讯作者：
Callen, JP
中科院分区：
文献类型：
--
作者：
Waldman, MA;Callen, JP
在移植患者和结缔组织疾病患者中使用免疫抑制剂后，自我消退的EB病毒（EBV）相关淋巴瘤变得更加常见。免疫抑制剂通常用于控制皮肌炎，但其使用与随后的恶性肿瘤无关。我们报告一位46岁女性皮肌炎患者，在口服甲氨蝶呤、霉酚酸酯和低剂量泼尼松治疗期间发生EB病毒相关性脑B细胞淋巴瘤。在停用甲氨蝶呤和吗替麦考酚酯后，患者的淋巴瘤逐渐“自发”消退。临床医生应认识到EBV相关B细胞淋巴瘤自我消退的可能性，以防止不必要的和潜在的毒性治疗，包括放射治疗或多药化疗。
Self-resolving Epstein-Barr virus (EBV)-associated lymphomas have become more common with the use of immunosuppressive agents in both transplant patients and patients with connective tissue disorders. Immunosuppressive agents are often used for control of dermatomyositis, but their use has not been linked to subsequent malignancy. We present a 46-year-old woman with dermatomyositis, who developed an EBV-associated B-cell lymphoma of the brain while on oral methotrexate, mycophenolate mofetil and low-dose prednisone. The patient's lymphoma gradually resolved "spontaneously" upon discontinuation of the methotrexate and mycophenolate mofetil. The potential for EBV-associated B-cell lymphoma to selfresolve should be recognized by the clinician in order to prevent unnecessary and potentially toxic treatments including radiation therapy or multi-drug chemotherapy.