Reversible lymphoproliferative disorder in systemic lupus erythematosus treated with mycophenolate mofetil: A case report and literature review.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-05-01 Epub Date: 2025-03-28 DOI:10.1177/09612033251330101
Hiroto Tomoda, Muneo Nakaya, Seiichiro Nakabeppu, Hiroaki Miyoshi, Koichi Ohshima, Yuji Miyoshi
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引用次数: 0

Abstract

BackgroundMycophenolate mofetil (MMF) is widely used to treat systemic lupus erythematosus (SLE), particularly in cases with severe and organ-threatening complications such as lupus nephritis. However, multiple reports have documented lymphoproliferative disorder (LPD) in patients with SLE undergoing MMF therapy, predominantly developing in the central nervous system and requiring aggressive treatment, including chemotherapy, radiation, and surgery.Case ReportWe herein report the case of a 58-year-old female patient with SLE who developed cervical, hepatic hilar, and para-aortic lymphadenopathy 8 years after initiating MMF treatment. Histopathological examination of the left cervical lymph node revealed features consistent with polymorphic LPD. MMF was discontinued, and after 2 months of surveillance, the enlarged lymph nodes regressed without need for additional treatment.ConclusionTo the best of our knowledge, this is the first reported case of MMF-associated LPD occurring outside the central nervous system in a patient with SLE, which resolved spontaneously upon MMF withdrawal. Clinicians should remain vigilant regarding the possibility of MMF-associated LPD when administering MMF to patients with SLE.

霉酚酸酯治疗系统性红斑狼疮可逆淋巴细胞增生性疾病1例报告并文献复习。
霉酚酸酯(MMF)被广泛用于治疗系统性红斑狼疮(SLE),特别是在严重和器官威胁的并发症,如狼疮肾炎的情况下。然而,有多篇报道表明,在接受MMF治疗的SLE患者中出现淋巴增生性疾病(LPD),主要发生在中枢神经系统,需要积极的治疗,包括化疗、放疗和手术。病例报告我们在此报告一例58岁的SLE女性患者,在开始MMF治疗8年后出现颈部、肝门部和主动脉旁淋巴结病变。左侧颈部淋巴结组织病理学检查显示与多形性LPD相符。停止MMF治疗,2个月后,肿大的淋巴结消退,无需额外治疗。据我们所知,这是第一例在SLE患者中枢神经系统外发生MMF相关LPD的报道,该病例在MMF停药后自行消退。临床医生在给SLE患者使用MMF时应警惕MMF相关LPD的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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