• Yuki Nakayama, Naoki Sawa, Tatsuya Suwabe, Masayuki Yamanouchi, Daisuke Ikuma, Hiroki Mizuno, Eiko Hasegawa, Akinari Sekine, Yuki Oba, Kazuya Ishiwata, Atsushi Wake, Masaki Hatano, Izuru Kitajima, Kei Kono, Keiichi Kinowaki, Yutaka Takazawa, Tamiko Takemura, and Yoshifumi Ubara.
• Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan.
• Intern. Med. 2024 Mar 15; 63 (6): 867871867-871.

AbstractA 58-year-old woman with rheumatoid arthritis was diagnosed with methotrexate-associated Hodgkin lymphoma. After receiving several chemotherapy regimens, she started nivolumab treatment. Two weeks later, she was hospitalized with worsening finger, wrist, and elbow joint pain. A synovial biopsy of the wrist joint showed villous synovial proliferation and linear infiltration of CD68-/CD3-positive T cells (with more CD8 than CD4 T cells) but no CD20-positive B cells or CD138-positive macrophages. These findings corresponded to synovitis associated with immune-related adverse events, which are induced mainly by T cells and are different from typical rheumatoid arthritis (RA), in which B cells play a central role.

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