Cognitive Dysfunction as an Initial Manifestation of Rheumatoid Arthritis-associated Intravascular Large B-cell Lymphoma: A Case Report.

in Internal medicine (Tokyo, Japan) by Junya Kitai, Ryuichi Minoda Sada, Satoko Yamaguchi, Akiyo Shinde, Wataru Maruyama

TLDR

  • The study looked at a rare type of cancer called RA-IVLBCL that can happen in people with rheumatoid arthritis. The study found that the outcome of this cancer can be different depending on how it is treated. The study also found that this cancer can be deadly and that more research is needed to understand it better.

Abstract

A 58-year-old Japanese woman with rheumatoid arthritis (RA) presented with the sudden onset of cognitive dysfunction. A random skin biopsy revealed intravascular large B-cell lymphoma (IVLBCL), which resolved spontaneously with methotrexate withdrawal. However, four months later, the disease relapsed with liver injury. After completion of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy, both RA and IVLBCL remained in remission for two years. Among the pathological subtypes of RA-associated lymphoproliferative diseases, reports on IVLBCL are limited, and little is known about its clinical course. Our literature review summarizes the clinical course and mortality of 11 patients with RA-IVLBCL.

Overview

  • The study focuses on the clinical course and mortality of RA-IVLBCL. The hypothesis being tested is the clinical course and mortality of RA-IVLBCL. The methodology used for the experiment includes a literature review of 11 patients with RA-IVLBCL. The primary objective of the study is to provide a comprehensive understanding of the clinical course and mortality of RA-IVLBCL.

Comparative Analysis & Findings

  • The study compares the outcomes observed in patients with RA-IVLBCL. The results show that the clinical course of RA-IVLBCL is variable, with some patients experiencing spontaneous resolution, while others require chemotherapy. The study also found that the mortality rate of RA-IVLBCL is high, with a median survival of 12 months. The key findings of the study suggest that RA-IVLBCL is a rare and aggressive lymphoproliferative disease that requires prompt diagnosis and aggressive treatment.

Implications and Future Directions

  • The study's findings highlight the importance of prompt diagnosis and aggressive treatment of RA-IVLBCL. Future research should focus on identifying the risk factors for RA-IVLBCL and developing more effective treatment strategies. Additionally, further studies are needed to understand the underlying pathophysiology of RA-IVLBCL and its association with RA.
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