RESUMEN
We describe 2 patients with seropositive rheumatoid arthritis treated with methotrexate (MTX) who developed Hodgkin's disease (HD) and non-Hodgkin's lymphoma. Followup allowed a lymph node biopsy at 4 different time points in 1 patient and at 2 in the other. In the first patient, the steps included a long history of benign follicle hyperplasia, a polymorphic diffuse B cell lymphoproliferation, and finally HD unassociated with Epstein-Barr virus (EBV). In the second patient, a polymorphic diffuse lymphoproliferation was followed by a monomorphic large B cell lymphoproliferation associated with EBV. The cytogenetic analysis showed a monoclonal proliferation associated with the same chromosomal abnormalities found in 1 of the clones observed in the initial biopsy. These 2 cases illustrate the complexity of the role of MTX in the outbreak of such manifestations.
Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Metotrexato/uso terapéutico , Anciano , Biopsia , Femenino , Enfermedad de Hodgkin/inducido químicamente , Humanos , Ganglios Linfáticos/patología , Linfoma no Hodgkin/inducido químicamente , Trastornos Linfoproliferativos/inducido químicamente , Masculino , Metotrexato/efectos adversos , Persona de Mediana EdadAsunto(s)
Vectores Arácnidos/microbiología , Infecciones por Borrelia/epidemiología , Enfermedad de Lyme/epidemiología , Garrapatas/microbiología , Altitud , Animales , Borrelia/fisiología , Infecciones por Borrelia/transmisión , Reservorios de Enfermedades , Femenino , Humanos , Enfermedad de Lyme/transmisión , Masculino , SuizaAsunto(s)
Miositis Osificante/diagnóstico por imagen , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Miositis Osificante/diagnóstico , Enfermedades de la Columna Vertebral/diagnóstico , UltrasonografíaRESUMEN
After the successful identification of Borrelia burgdorferi as the cause of Lyme disease, a new tick-borne infection occurring in the United States, almost identical spirochaetes have been isolated from the tick Ixodes ricinus in Europe. As a result, the spirochaetal aetiology of skin diseases, which had long been recognized as tick-borne infections, namely erythema chronicum migrans with its neurological complications of the tick-borne meningopolyneuritis of Garin-Bujadoux-Bannwarth, acrodermatitis chronica atrophicans and lymphadenosis cutis benigna, could be confirmed by means of microbiological, histological and serological methods. On the basis of case histories it had already been assumed for some time that anetodermia maculosa and the localised sclerodermas might also be caused by a tick-borne agent. The results of serological investigations have now strengthened this assumption, although microbiological confirmation is still lacking.
Asunto(s)
Mordeduras y Picaduras/complicaciones , Infecciones por Spirochaetales/transmisión , Garrapatas , Acrodermatitis/transmisión , Dermatitis/transmisión , Humanos , Enfermedad de Lyme/transmisión , Linfadenitis/transmisión , Meningitis/transmisión , Polineuropatías/transmisión , Esclerodermia Localizada/transmisiónRESUMEN
The authors report a case of a bone metastasis in the thumb initially considered as an arterio-venous angioma revealing a kidney cancer; they insist on its rarity and the difficulties of the diagnosis before osseous biopsy.