ABSTRACT
Methotrexate (MTX) is used in the treatment of a variety of diseases such as rheumatoid arthritis, dermatomyositis, juvenile rheumatoid arthritis and chronic plaque psoriasis. It has been well documented that there is a risk of development of lymphomas in these patients although none have been reported in patients of psoriasis treated with methotrexate. A 58-year-old male patient, a known case of psoriasis since 1994, had been receiving treatment with a low dose of MTX, 5 mg weekly for ten years intermittently (7-8 months/year). The cumulative dose of MTX taken was 1.5 gm. He developed high-grade fever with cervical lymphadenopathy that was nonresponsive to routine line of management. Lymph node biopsy revealed the presence of mixed cellularity type of Hodgkin's lymphoma. CT scan showed cervical, mediastinal and abdominal lymphadenopathy. The patient responded well to withdrawal of MTX and chemotherapy. This is the first case of lymphoma occurring in a patient of psoriasis treated with low-dose MTX.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Dermatologic Agents/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Hodgkin Disease/chemically induced , Humans , Injections, Intravenous , Male , Methotrexate/administration & dosage , Middle Aged , Psoriasis/drug therapy , Remission Induction , Tomography, X-Ray ComputedABSTRACT
En este trabajo, 34 pacientes con Linfoma (L) fueron estudiados prospectivamente, para determinar el valor diagnóstico de las alteraciones citogenéticas (AC) observadas en linfocitos en sangre periférica, médula ósea, ganglio linfático y líquido ascítico. La mayoría de los 11 pacientes con EH eran adolescentes o adultos jóvenes en estadio avanzado de la enfermedad. Los 23 pacientes con LNH eran mayores de 16 años, con una gran variedad de formas histológicas y se encontraban en estadio IV de la enfermedad. Más del 80 por ciento de los pacientes mostraron AC; las aneuploidías, translocaciones, delecciones y otros cambios estructurales cromosómicos; 3 pacientes con EH y 2 con LNH mostraron cromosoma Philadhelphia positivo, pareciendo tener este hallazgo un significado pronóstico sombrío en este último grupo. En los pacientes que fallecieron se observó en EH en forma simultánea, monosomía 22 y 7, y en LNH alteraciones estructurales y monosomía 22