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Article: Diffuse large B-cell lymphoma of the central nervous system in mycophenolate mofetil-treated patients with systemic lupus erythematosus

TitleDiffuse large B-cell lymphoma of the central nervous system in mycophenolate mofetil-treated patients with systemic lupus erythematosus
Authors
KeywordsEpstein-Barr virus
Immunosuppression
Lymphoma
Mycophenolate mofetil
Systemic lupus erythematosus
Issue Date2010
PublisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.com
Citation
Lupus, 2010, v. 19 n. 3, p. 330-333 How to Cite?
AbstractPatients with systemic lupus erythematosus (SLE) are susceptible to the development of lymphoproliferative disorders and postulated causes include intrinsic defects in immune surveillance and iatrogenic administration of immunosuppressants. Since the introduction of mycophenolate mofetil (MMF) to the immunosuppressive regimen for the management of post-organ transplantation, there have been reports of primary lymphoma of the central nervous system (PCNSL). MMF has been widely used to treat active SLE patients with Class IV lupus nephritis. In addition to two previously reported cases of PCNSL among SLE patients on long-term MMF, we report a third patient who has been on treatment with MMF for 8 years. The histology showed features compatible with diffuse large B-cell lymphoma with strong immunohistochemical staining for CD20 and positive signal for Epstein-Barr virus (EBV)-encoded RNA by in-situ hybridization that is similar to other case reports, suggesting EBV driven B-cell lymphoproliferative disease. The patient responded to withdrawal of MMF, intravenous methotrexate, rituximab and whole brain radiotherapy. With the increasing use of MMF in active renal as well as non-renal exacerbations of SLE, PCNSL should be included in the differential diagnosis in patients who present with gradual onset of focal neurological deficit.
Persistent Identifierhttp://hdl.handle.net/10722/77488
ISSN
2015 Impact Factor: 2.118
2015 SCImago Journal Rankings: 0.878
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTsang, HHLen_HK
dc.contributor.authorTrendellSmith, NJen_HK
dc.contributor.authorWu, AKPen_HK
dc.contributor.authorMok, MYen_HK
dc.date.accessioned2010-09-06T07:32:26Z-
dc.date.available2010-09-06T07:32:26Z-
dc.date.issued2010en_HK
dc.identifier.citationLupus, 2010, v. 19 n. 3, p. 330-333en_HK
dc.identifier.issn0961-2033en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77488-
dc.description.abstractPatients with systemic lupus erythematosus (SLE) are susceptible to the development of lymphoproliferative disorders and postulated causes include intrinsic defects in immune surveillance and iatrogenic administration of immunosuppressants. Since the introduction of mycophenolate mofetil (MMF) to the immunosuppressive regimen for the management of post-organ transplantation, there have been reports of primary lymphoma of the central nervous system (PCNSL). MMF has been widely used to treat active SLE patients with Class IV lupus nephritis. In addition to two previously reported cases of PCNSL among SLE patients on long-term MMF, we report a third patient who has been on treatment with MMF for 8 years. The histology showed features compatible with diffuse large B-cell lymphoma with strong immunohistochemical staining for CD20 and positive signal for Epstein-Barr virus (EBV)-encoded RNA by in-situ hybridization that is similar to other case reports, suggesting EBV driven B-cell lymphoproliferative disease. The patient responded to withdrawal of MMF, intravenous methotrexate, rituximab and whole brain radiotherapy. With the increasing use of MMF in active renal as well as non-renal exacerbations of SLE, PCNSL should be included in the differential diagnosis in patients who present with gradual onset of focal neurological deficit.en_HK
dc.languageengen_HK
dc.publisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.comen_HK
dc.relation.ispartofLupusen_HK
dc.rightsLupus. Copyright © Sage Publications Ltd.en_HK
dc.subjectEpstein-Barr virusen_HK
dc.subjectImmunosuppressionen_HK
dc.subjectLymphomaen_HK
dc.subjectMycophenolate mofetilen_HK
dc.subjectSystemic lupus erythematosusen_HK
dc.subject.meshAntibodies, Monoclonal - therapeutic use-
dc.subject.meshImmunosuppressive Agents - adverse effects - therapeutic use-
dc.subject.meshLupus Erythematosus, Systemic - drug therapy-
dc.subject.meshLymphoma, Large B-Cell, Diffuse - etiology - therapy - virology-
dc.subject.meshMycophenolic Acid - adverse effects - analogs and derivatives - therapeutic use-
dc.titleDiffuse large B-cell lymphoma of the central nervous system in mycophenolate mofetil-treated patients with systemic lupus erythematosusen_HK
dc.typeArticleen_HK
dc.identifier.emailMok, MY:temy@hkucc.hku.hken_HK
dc.identifier.authorityMok, MY=rp00490en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1177/0961203309347921en_HK
dc.identifier.pmid19897521-
dc.identifier.scopuseid_2-s2.0-77749292033en_HK
dc.identifier.hkuros166741en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77749292033&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue3en_HK
dc.identifier.spage330en_HK
dc.identifier.epage333en_HK
dc.identifier.isiWOS:000274783600015-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTsang, HHL=36795173500en_HK
dc.identifier.scopusauthoridTrendellSmith, NJ=6602816986en_HK
dc.identifier.scopusauthoridWu, AKP=36088363500en_HK
dc.identifier.scopusauthoridMok, MY=7006024184en_HK

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