Methotrexate-associated Angioimmunoblastic T-cell Lymphoma Presenting with Acute Kidney Injury
Satoshi Ichikawa1,2, Hikaru Kumagai1, Koichi Onodera2
1Division of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University, Japan.
Abstract:
A man in his 60s on methotrexate for rheumatoid arthritis developed a fever and lymph node swelling, suggesting a lymphoproliferative disorder. Methotrexate was discontinued; however, the patient was admitted for acute kidney injury (AKI) and thrombocytopenia. Blood tests showed high levels of inflammatory markers, positive plasma Epstein-Barr virus DNA, and CD10-positive abnormal T cells, indicating T-cell neoplasm. CHOP chemotherapy with continuous hemodiafiltration improved the patient's condition. A lymph node biopsy confirmed the diagnosis of angioimmunoblastic T-cell lymphoma (AITL). To our knowledge, this is the first reported case of methotrexate-associated AITL complicated by AKI with a successful treatment course.
Related Concept Videos
Acute Kidney Injury I: Introduction
Acute Kidney Injury II: Pathophysiology
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Acute Kidney Injury III: Clinical Manifestations
Kidney Transplant II: Surgical Procedure
Acute Kidney Injury V: Interprofessional Care


