Choledochoduodenal Fistula during Chemotherapy with Brentuximab Vedotin for Methotrexate-associated Lymphoproliferative Disorder
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- Eso Yuji
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
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- Uza Norimitsu
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
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- Shirakawa Kotaro
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan
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- Sawada Kenji
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
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- Katsuragi Kentaro
- Integrated Clinical Education Center, Kyoto University Hospital, Japan
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- Matsuura Minoru
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
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- Seno Hiroshi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
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Abstract
<p>We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy. It should be noted that, in cases of lymphoma infiltrating the gastrointestinal wall, fistulae can occur because of rapid regression due to regimens comprising monoclonal antibodies, such as rituximab and brentuximab vedotin. </p>
Journal
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- Internal Medicine
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Internal Medicine 57 (15), 2203-2207, 2018-08-01
The Japanese Society of Internal Medicine
