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. c 2019 Japanese Society of Internal Medicine.
雑誌名
Internal Medicine
巻
58
号
22
ページ
3331 - 3336
発行年
2019-11-15
出版者
日本内科学会
出版者別言語
Japanese Society of Internal Medicine
ISSN
09182918
EISSN
13497235
DOI
10.2169/internalmedicine.2782-19
権利
c 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/).
Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis
IntMed58_3331.pdf
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