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Other iatrogenic immunodeficiency lymphoproliferative disorder induced by corticosteroid used for an autoimmune disorder.

Abstract
Other iatrogenic immunodeficiency lymphoproliferative disorders (oii-LPD) are defined as lymphoid proliferations or lymphomas that occur in patients taking immunosuppressive agents (ISA) for autoimmune disorders (AID). Although methotrexate and tumor necrosis factor-alpha inhibitors cause oii-LPD, the association between corticosteroids and lymphomagenesis remains unknown. Herein, we present the case of a 51-year-old woman with oii-LPD caused by corticosteroid use for autoimmune hemolytic anemia (AIHA). The diagnosis of AIHA was made in May 2016, and AIHA had been well-controlled for 5 years with oral prednisolone (PSL). During a regular follow-up visit in March 2022, an abnormal increase in atypical lymphoid cells in the peripheral blood was found. The bone marrow biopsy specimens showed local aggregations of large cells that were identified as lymphoplasmacytic cells and plasma cells, and that were positive for cluster of differentiation (CD)19 and CD20, with apparent nucleoli among the diffuse infiltration of atypical small lymphocytes. The large cells were partially positive for the Epstein-Barr encoding region in situ hybridization and latent membrane protein 1, which confirmed Epstein-Barr virus (EBV)-affected lymphomagenesis. To our knowledge, this is the first report of an oii-LPD case shown to be induced by corticosteroid use for AID.
AuthorsKenichi Ito, Yoshihito Uchino, Kazuhiko Hirano, Naohiro Sekiguchi
JournalThe Journal of international medical research (J Int Med Res) Vol. 50 Issue 12 Pg. 3000605221144149 (Dec 2022) ISSN: 1473-2300 [Electronic] England
PMID36518090 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Adrenal Cortex Hormones
Topics
  • Female
  • Humans
  • Middle Aged
  • Herpesvirus 4, Human
  • Epstein-Barr Virus Infections (complications)
  • Lymphoproliferative Disorders (chemically induced, diagnosis, pathology)
  • Autoimmune Diseases (complications)
  • Immunologic Deficiency Syndromes
  • Adrenal Cortex Hormones (adverse effects)
  • Iatrogenic Disease

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