Lymphadenopathy in a patient with systemic onset juvenile chronic arthritis

Two large studies of 16â[euro][per thousand]263 and 5803 RA patients respectively found no evidence of a significant increase in risk of malignancies in those treated with methotrexate. 22 23 The confidence intervals in the second study for the risk of developing any malignancy were wide (0.3 to 10...

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Bibliographic Details
Published in:Annals of the rheumatic diseases 1998-09, Vol.57 (9), p.513-517
Main Authors: Munro, R, Porter, D R, Sturrock, R D
Format: Article
Language:English
Subjects:
Anorexia
Antirheumatic Agents - adverse effects
Arthritis
Arthritis, Juvenile - complications
Arthritis, Juvenile - diagnosis
Arthritis, Juvenile - drug therapy
Biological and medical sciences
Biopsy
Chemotherapy
Child
Confidence intervals
Diagnosis, Differential
Diseases of the osteoarticular system
Epstein-Barr Virus Infections - complications
Fever
Hematology
Hodgkin Disease - complications
Hodgkin Disease - diagnosis
Humans
Immunosuppressive Agents - adverse effects
Infections
Inflammatory joint diseases
lymphadenopathy
Lymphoma
Male
Masterclass
Medical sciences
Methotrexate - adverse effects
systemic onset juvenile chronic arthritis
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Summary:Two large studies of 16â[euro][per thousand]263 and 5803 RA patients respectively found no evidence of a significant increase in risk of malignancies in those treated with methotrexate. 22 23 The confidence intervals in the second study for the risk of developing any malignancy were wide (0.3 to 10) and it is possible neither study had significant power to truly answer the question despite their large sample sizes. The existence of only one other case report for systemic onset JCA is possibly partly because of the relatively small number of children being treated with methotrexate compared with the estimated 100â[euro][per thousand]000 to 200â[euro][per thousand]000 RA patients currently being treated with methotrexate. 24 Potentially the strongest evidence to implicate methotrexate is spontaneous regression of the lymphoproliferative disorder in a number of cases on cessation of methotrexate without the requirement for chemotherapy. 25-27 Our case received chemotherapy as, at the time he was treated, the phenomenon of regression with withdrawal of methotrexate alone had not been fully reported.
ISSN:0003-4967
1468-2060
DOI:10.1136/ard.57.9.513