Reactions 1704, p16 - 2 Jun 2018 Epstein-Barr virus-related lymphoproliferative disorder: case report A 51-year-old woman developed Epstein-Barr virus-related lymphoproliferative disorder during treatment with adalimumab for psoriatic arthritis. The woman, who had psoriatic arthritis, had been receiving therapy with infliximab and methotrexate for 12 years. Her infliximab was switched to adalimumab due to the worsening of psoriatic arthritis on 20 December 2016 [route and dosage not stated]. She showed development of rapidly enlarging cervical lymph nodes after three adalimumab doses, which were administered one week apart. On 13 January 2017, an excisional biopsy was carried out. On 27 January 2017, F- FDG PET/CT showed intense FDG uptake in thoracic, abdominal, cervical and pelvic lymph nodes and widespread hypermetabolic lymphadenopathy. The woman’s adalimumab therapy was withdrawn, and the size of the cervical lymph nodes reduced. Biopsy showed Epstein-Barr virus-related polymorphic lymphoproliferative disorder. Five weeks after the withdrawal of adalimumab, follow-up F-FDG PET/CT showed almost complete resolution of the FDG uptake and adenopathy. Author comment: "Tumor necrosis factor α (TNF-α) is an important cytokine in the innate immune response against EBV infection. The use of TNF-α inhibitors therefore may lead to an increased risk of developing EBV-related LPDs." "Regression after drug discontinuation seldom occurs in patients who developed the disorders following anti–TNF-α antagonists as in this case." Ward J, et al. Adalimumab-Induced Epstein-Barr Virus-Related Lymphoproliferative Disorder on FDG PET/CT. Clinical Nuclear Medicine 43: 344-345, No. 5, May 2018. Available from: URL: http://doi.org/10.1097/ RLU.0000000000002054 - United Kingdom 803322764 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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