メトトレキサート内服中の関節リウマチ患者に生じた免疫不全関連リンパ増殖性疾患

・メトトレキサート（MTX）内服中の関節リウマチ（RA）患者に生じた免疫不全関連リンパ増殖性疾患（immunodeficiency-associated lymphoproliferative disorders；IDLPD）を報告した． ・過去10年の報告では，眼瞼部皮膚MTX-IDLPDは自験例のみ． ・MTX内服の中止により寛解を得られた． （「症例のポイント」より）

A case of immunodeficiency-associated lymphoproliferative disorders occurring in patients with rheumatoid arthritis treated with methotrexate Kuwahara, Fumi1）Ohyama, Bungo1）Ishii, Norito1）Ohata, Chika1）Nagafuji, Kouji2）Nakama, Takekuni1） 1）Department of Dermatology, Kurume University School of Medicine 2）Division of Hematology and Oncology, Kurume University School of Medicine Abstract 44-year-old woman treated rheumatoid arthritis with methotrexate (MTX)for 4 years. She complained of rapidly enlarging nodule of the right eyelid of 5 month duration. Histopathology found infiltration of large atypical lymphocytes in dermis. Immunohistochemistory found positive CD20 lymphocytes and negative CD3 lymphocytes, and histopathology was diagnosed diffuse large B cell lymphoma. We diagnosed as Immunodeficiency -related lymphoproliferative disease. Administration of MTX was discontinued,and the nodule regressed spontaneously without medications.