Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis

Shiho Toyama, Ayuko Takatani, Tomohiro Koga, Mizuna Eguchi, Momoko Okamoto, Sosuke Tsuji, Yushiro Endo, Toshimasa Shimizu, Remi Sumiyoshi, Takashi Igawa, Shin ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Masako Furuyama, Maiko Tabuchi, Shinichiro Kobayashi, Kengo KanetakaMikiko Hashisako, Kuniko Abe, Daisuke Niino, Shinya Sato, Yasushi Miyazaki, Atsushi Kawakami

Research output: Contribution to journalArticle

Abstract

A 71-year-old woman being treated with methotrexate (MTX) and tacrolimus (TAC) for rheumatoid arthritis (RA) was admitted to our hospital and underwent surgery for gastric perforation and peritonitis. An endoscopic examination six days post-surgery showed an extensive ulcer in the stomach, and a biopsy revealed diffused large B-cell lymphoma. We diagnosed her with immunodeficiency-associated lymphoproliferative disorder (LPD) and discontinued the MTX and TAC. She underwent gastrectomy due to stenosis approximately two months after the first operation, but the histopathological findings of lymphoma had disappeared. LPD should be considered as a potential cause of gastric perforation during RA treatment.

Original languageEnglish
Pages (from-to)3331-3336
Number of pages6
JournalInternal Medicine
Volume58
Issue number22
DOIs
Publication statusPublished - Jan 1 2019

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Lymphoproliferative Disorders
Tacrolimus
Methotrexate
Rheumatoid Arthritis
Stomach
B-Cell Lymphoma
Stomach Ulcer
Gastrectomy
Peritonitis
Ambulatory Surgical Procedures
Lymphoma
Pathologic Constriction
Biopsy
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis. / Toyama, Shiho; Takatani, Ayuko; Koga, Tomohiro; Eguchi, Mizuna; Okamoto, Momoko; Tsuji, Sosuke; Endo, Yushiro; Shimizu, Toshimasa; Sumiyoshi, Remi; Igawa, Takashi; Kawashiri, Shin ya; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Furuyama, Masako; Tabuchi, Maiko; Kobayashi, Shinichiro; Kanetaka, Kengo; Hashisako, Mikiko; Abe, Kuniko; Niino, Daisuke; Sato, Shinya; Miyazaki, Yasushi; Kawakami, Atsushi.

In: Internal Medicine, Vol. 58, No. 22, 01.01.2019, p. 3331-3336.

Research output: Contribution to journalArticle

Toyama, S, Takatani, A, Koga, T, Eguchi, M, Okamoto, M, Tsuji, S, Endo, Y, Shimizu, T, Sumiyoshi, R, Igawa, T, Kawashiri, SY, Iwamoto, N, Ichinose, K, Tamai, M, Nakamura, H, Origuchi, T, Furuyama, M, Tabuchi, M, Kobayashi, S, Kanetaka, K, Hashisako, M, Abe, K, Niino, D, Sato, S, Miyazaki, Y & Kawakami, A 2019, 'Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis', Internal Medicine, vol. 58, no. 22, pp. 3331-3336. https://doi.org/10.2169/internalmedicine.2782-19
Toyama, Shiho ; Takatani, Ayuko ; Koga, Tomohiro ; Eguchi, Mizuna ; Okamoto, Momoko ; Tsuji, Sosuke ; Endo, Yushiro ; Shimizu, Toshimasa ; Sumiyoshi, Remi ; Igawa, Takashi ; Kawashiri, Shin ya ; Iwamoto, Naoki ; Ichinose, Kunihiro ; Tamai, Mami ; Nakamura, Hideki ; Origuchi, Tomoki ; Furuyama, Masako ; Tabuchi, Maiko ; Kobayashi, Shinichiro ; Kanetaka, Kengo ; Hashisako, Mikiko ; Abe, Kuniko ; Niino, Daisuke ; Sato, Shinya ; Miyazaki, Yasushi ; Kawakami, Atsushi. / Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis. In: Internal Medicine. 2019 ; Vol. 58, No. 22. pp. 3331-3336.
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AU - Kanetaka, Kengo

AU - Hashisako, Mikiko

AU - Abe, Kuniko

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