• Internal medicine · Dec 2022

    Prognosis Prediction Using Magnetic Resonance Spectroscopy and Oligoclonal Bands in Central Nervous System Methotrexate-associated Lymphoproliferative Disorder.

    • Hiroki Ueno, Narumi Ohno, Takafumi Abe, Kazuki Kimoto, Chika Matsuoka, Mayumi Giga, Hiroyuki Naito, Tomoyuki Kono, Miyuki Takasu, Naoya Kidani, Rie Yamasaki, Koichi Ichimura, and Eiichi Nomura.
    • Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Japan.
    • Intern. Med. 2022 Dec 15; 61 (24): 373337383733-3738.

    AbstractCentral nervous system methotrexate-associated lymphoproliferative disorder (CNS-MTX-LPD) is rare, but its spontaneous regression has been observed in some patients after withdrawal of agents. We herein report three cases of primary CNS-MTX-LPD that received oral MTX for rheumatoid arthritis. Epstein-Barr virus and oligoclonal bands (OCBs) were positive, while proton magnetic resonance spectroscopy (1H-MRS) showed an elevated lipid peak and slightly elevated choline/N-acetylaspartate ratio in common. After MTX withdrawal, brain lesions showed spontaneous regression in all cases. Our patient's 1H-MRS findings and OCBs may reflect a non-monoclonal lymphoproliferative histology as benign-type lesions in CNS-MTX-LPD.

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