ID 112059
Title Alternative
Development of adult T-cell leukemia/lymphoma during immunosuppressive therapy for human T-cell leukemia virus type 1 associated arthropathy
HTVL‐1キャリアへの免疫抑制療法中に発症したATLL
Author
Yamaguchi, Sumiyo Tokushima University
Sumida, Satoshi Tokushima University
Maeda, Yusaku Tokushima University
Takahashi, Mamiko Tokushima University
Iwasa, Masami Tokushima University
Kishi, Jun The University of Tokushima KAKEN Search Researchers
Keywords
Adult T-cell leukemia/lymphoma
HTLV‐1
rheumatoid arthritis
immunosuppressive therapy
Content Type
Journal Article
Description
A 64-year-old woman presented with lower leg edema, fever, and bilateral joint pain, involving the wrists, fingers, and knees, in April 201X. Serological test results were negative for rheumatoid factor, antinuclear antibody, and anti-cyclic citrullinated peptide antibody. A diagnosis of remitting seronegative symmetrical synovitis with pitting edema syndrome, a type of seronegative rheumatoid arthritis, was made and prednisolone was administered. The joint pain was refractory to prednisolone therapy. In February, 201X+2, the patient presented with right cervical lymphadenopathy. The CT scan revealed swelling of the cervical, axillary, and inguinal lymph nodes bilaterally and rapidly enlarged. In April, 18F-fluorodeoxyglucose PET/CT scan showed an abnormal collection in the enlarged lymph nodes. The patient subsequently developed hoarseness with dyspnea and attended our department. Blood test results showed high levels of lactate dehydrogenase (547U/L) and soluble interleukin‐2 receptor (34200 IU/L) and were positive for anti-human T-cell leukemia virus type1 (HTLV‐1) antibody. Biopsy of the right cervical lymph node showed proliferation of abnormal lymphoid cells positive for CD3, CD4, and CD25 and negative for CD7. Monoclonal integration of HTLV‐1 proviral DNA was detected in the lymph node. A diagnosis of adult T-cell leukemia/lymphoma (ATLL), lymphoma type was made. The pain involving multiple joints was attributed to HTLV‐1associated arthropathy. Immunosuppressive therapy for HTLV‐1 carrier status may have played a role in the development of ATLL.
Journal Title
Shikoku Acta Medica
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
73
Issue
5-6
Start Page
301
End Page
308
Sort Key
301
Published Date
2017-12-25
FullText File
language
jpn
TextVersion
Publisher
departments
Medical Sciences
University Hospital