Methotrexate‐related lymphoproliferative disorder arising in the gingiva of a patient with rheumatoid arthritis. (24th July 2015)

• Record Type: Journal Article
• Authors: Horie, N; Kawano, R; Kaneko, T; Shimoyama, T
• Is Part Of: Australian dental journal. Volume 60:Number 3(2015:Sep.)
• Page Start: 408
• Page End: 411
• Publication Date: 2015-07-24
• Subjects: Dentistry -- Periodicals; Dentistry -- Periodicals; Dentisterie -- Australie -- Périodiques; Tandheelkunde; 617.6
• DOI: 10.1111/adj.12235
• Languages: English
• ISSNs: 0045-0421

Abstract

<abstract abstract-type="main" id="adj12235-abs-0001"> <title>Abstract</title> <p>Methotrexate (MTX) is the primary drug used in the management of rheumatoid arthritis (RA) and other immune‐mediated inflammatory diseases. MTX is a strong immunosuppressive agent and has been reported to cause iatrogenic immunodeficiency‐associated lymphoproliferative disorders (LPDs). Stomatitis caused by MTX‐related cytotoxicity may occur, but gingival MTX‐related LPDs are rare. In this article we present a case of gingival MTX‐related LPD in a 60‐year‐old male with RA. The local findings of the gingival ulceration and alveolar bone exposure were similar to those of bisphosphonate‐related osteonecrosis of the jaw. However, he had never received bisphosphonate therapy. The biopsy specimen of the gingival lesion was diagnosed as diffuse large B‐cell lymphoma with Epstein‐Barr virus positivity. Immediate withdrawal of MTX resulted in marked remission of the LPD.</p> </abstract>