Vol.20 No.5

Case Report

CD8+ T-cell lymphoproliferative disorder associated with Epstein?Barr virus in a patient with rheumatoid arthritis during methotrexate therapy

Authors

Saori Hatachi1 , Akane Kunitomi2 , Katsuyuki Aozasa3 , Masato Yagita1

  • Division of Clinical Immunology and Rheumatology, Department of Medicine, Kitano Hospital
  • Department of Hematology, Japanese Red Cross Society Wakayama Medical Center
  • Department of Pathology, Osaka University Graduate School of Medicine
Received:

27 November 2009

Accepted:

19 March 2010

Published online:

1 May 2010

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Abstract

A 75-year-old woman with rheumatoid arthritis (RA) who was receiving methotrexate (MTX) therapy developed Epstein?Barr virus (EBV)-associated CD8+ T-cell lymphoproliferative disorder (LPD) and meningoencephalitis. She was successfully treated with acyclovir and corticosteroids plus MTX cessation. T-cell LPD is relatively rare in RA patients receiving MTX. To our knowledge, this is the first report of CD8+ T-cell LPD with EBV genome occurring during MTX therapy for RA. EBV infection should be carefully monitored to assess severe EBV-associated complications.

Key words

CD8 T cells - EBV - LPD - MTX - RA