Diffuse large B-cell lymphoma in a patient treated with azathioprine for ulcerative colitis: a case report.
| Autor: | Sedai H; Maharajgunj Medical Campus, Institute of Medicine., Shrestha S; Maharajgunj Medical Campus, Institute of Medicine., Chand V; Maharajgunj Medical Campus, Institute of Medicine., Poddar E; Maharajgunj Medical Campus, Institute of Medicine., Acharya S; Departments of Internal Medicine., Koirala D; Gastroenterology and Hepatology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2023 Apr 07; Vol. 85 (5), pp. 2059-2063. Date of Electronic Publication: 2023 Apr 07 (Print Publication: 2023). |
| DOI: | 10.1097/MS9.0000000000000562 |
| Abstrakt: | Azathioprine (AZA) used as an immunomodulator agent in the management of inflammatory bowel disease (IBD) increases the risk of the development of lymphoma. Case Presentation: We present a case of a 45-year-old female receiving AZA for severe ulcerative colitis for 4 years. She presented with the chief complaints of bloody stool and abdominal pain for 1 month. Through a series of investigations including colonoscopy, contrast-enhanced computed tomography scan of the abdomen and pelvis, and biopsy with immunohistochemistry; she was diagnosed to have diffuse large B-cell lymphoma of the rectum. She is currently on a chemotherapeutic regimen and is planned for surgical resection after the completion of neoadjuvant therapy. Clinical Discussion: AZA is classified as a carcinogen by the International Agency for Research on Cancer. Prolonged exposure to higher doses of AZA increases the risk of developing lymphoma in IBD. Previous meta-analysis and research indicate that the risk of development of lymphoma after the use of AZA in IBD increases by about four- to six-fold, especially in older age groups. Conclusions: AZA may increase the susceptibility to developing lymphoma in IBD, but the benefit far outweighs the risk. Precautions must be taken in prescribing AZA in older individuals which mandates periodic screening. Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report. (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.) |
| Databáze: | MEDLINE |
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