ID 112059
タイトル別表記
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
著者
山口, 純代 徳島大学
住田, 智志 徳島大学
前田, 悠作 徳島大学
高橋, 真美子 徳島大学
岩佐, 昌美 徳島大学
キーワード
Adult T-cell leukemia/lymphoma
HTLV‐1
rheumatoid arthritis
immunosuppressive therapy
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
73
5-6
開始ページ
301
終了ページ
308
並び順
301
発行日
2017-12-25
EDB ID
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
医学系
病院