Oral methotrexate-related lymphoproliferative disease presenting with severe osteonecrosis of the Jaw: A case report and literature review

Sachiko Furukawa; Kazunari Oobu; Masafumi Moriyama; Shintaro Kawano; Saori Sako; Jun Nosuke Hayashida; Ryota Matsubara; Ken Ichi Ogata; Tamotsu Kiyoshima; Seiji Nakamura

doi:10.2169/internalmedicine.8946-17

Oral methotrexate-related lymphoproliferative disease presenting with severe osteonecrosis of the Jaw: A case report and literature review

Sachiko Furukawa, Kazunari Oobu, Masafumi Moriyama, Shintaro Kawano, Saori Sako, Jun Nosuke Hayashida, Ryota Matsubara, Ken Ichi Ogata, Tamotsu Kiyoshima, Seiji Nakamura

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Abstract

Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD. At seven months after the cessation of MTX treatment, the ulcerative and necrotic lesions had markedly decreased in size. A 1-year follow-up examination showed no evidence of recurrence and good RA control.

Original language	English
Pages (from-to)	575-581
Number of pages	7
Journal	Internal Medicine
Volume	57
Issue number	4
DOIs	https://doi.org/10.2169/internalmedicine.8946-17
Publication status	Published - 2018

All Science Journal Classification (ASJC) codes

Internal Medicine

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10.2169/internalmedicine.8946-17

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@article{497ecead3d204953b57449bbcb641dfc,

title = "Oral methotrexate-related lymphoproliferative disease presenting with severe osteonecrosis of the Jaw: A case report and literature review",

abstract = "Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD. At seven months after the cessation of MTX treatment, the ulcerative and necrotic lesions had markedly decreased in size. A 1-year follow-up examination showed no evidence of recurrence and good RA control.",

author = "Sachiko Furukawa and Kazunari Oobu and Masafumi Moriyama and Shintaro Kawano and Saori Sako and Hayashida, {Jun Nosuke} and Ryota Matsubara and Ogata, {Ken Ichi} and Tamotsu Kiyoshima and Seiji Nakamura",

note = "Funding Information: This work was supported in part by grants from the “Shiinoki Foundation (Kyushu University)”. Publisher Copyright: {\textcopyright} 2018 The Japanese Society of Internal Medicine.",

year = "2018",

doi = "10.2169/internalmedicine.8946-17",

language = "English",

volume = "57",

pages = "575--581",

journal = "Internal Medicine",

issn = "0918-2918",

publisher = "Japanese Society of Internal Medicine",

number = "4",

}

TY - JOUR

T1 - Oral methotrexate-related lymphoproliferative disease presenting with severe osteonecrosis of the Jaw

T2 - A case report and literature review

AU - Furukawa, Sachiko

AU - Oobu, Kazunari

AU - Moriyama, Masafumi

AU - Kawano, Shintaro

AU - Sako, Saori

AU - Hayashida, Jun Nosuke

AU - Matsubara, Ryota

AU - Ogata, Ken Ichi

AU - Kiyoshima, Tamotsu

AU - Nakamura, Seiji

PY - 2018

Y1 - 2018

N2 - Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD. At seven months after the cessation of MTX treatment, the ulcerative and necrotic lesions had markedly decreased in size. A 1-year follow-up examination showed no evidence of recurrence and good RA control.

AB - Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD. At seven months after the cessation of MTX treatment, the ulcerative and necrotic lesions had markedly decreased in size. A 1-year follow-up examination showed no evidence of recurrence and good RA control.

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U2 - 10.2169/internalmedicine.8946-17

DO - 10.2169/internalmedicine.8946-17

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AN - SCOPUS:85042070643

SN - 0918-2918

VL - 57

SP - 575

EP - 581

JO - Internal Medicine

JF - Internal Medicine

IS - 4

ER -

Oral methotrexate-related lymphoproliferative disease presenting with severe osteonecrosis of the Jaw: A case report and literature review

Abstract

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