Nodal T-Follicular Helper Cell Lymphoma, Angioimmunoblastic-Type, Diagnosed in a Patient with Psoriasis Following COVID-19 Vaccination under Adalimumab Treatment: A Causal Association?

IF 1 4区 医学 Q4 DERMATOLOGY Indian Journal of Dermatology Pub Date : 2024-06-26 DOI:10.4103/ijd.ijd_93_23
Chang-Yu Hsieh, Shan-Chi Yu, Jia-Arng Lee, Tsen-Fang Tsai
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Abstract

Biologics have expanded the armamentarium for psoriasis, but there has been a growing concern about the risk of lymphoma in patients under tumour necrosis factor (TNF)-α inhibitor and methotrexate. Besides, the mRNA-based coronavirus disease 2019 (COVID-19) vaccination was known to stimulate the proliferation of T-follicular helper cells. We report a case of a patient with psoriasis under adalimumab developing nodal T-follicular helper cell lymphoma, angioimmunoblastic-type following the mRNA-1273 COVID-19 vaccine. We suspect that adalimumab, methotrexate, Epstein-Barr virus (EBV) reactivation, previous reactive lymphoid hyperplasia and psoriasis per se predispose our patient to a lymphoma-prone condition, and the two doses of the mRNA vaccine act as the last straw.

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一名牛皮癣患者在阿达木单抗治疗下接种 COVID-19 疫苗后诊断出结节性 T 滤泡辅助细胞淋巴瘤(血管免疫母细胞型):因果关系?
生物制剂扩大了银屑病的治疗范围,但人们越来越担心使用肿瘤坏死因子(TNF)-α抑制剂和甲氨蝶呤的患者发生淋巴瘤的风险。此外,基于 mRNA 的冠状病毒病 2019(COVID-19)疫苗已知会刺激 T 滤泡辅助细胞的增殖。我们报告了一例使用阿达木单抗的银屑病患者在接种mRNA-1273 COVID-19疫苗后发生结节性T滤泡辅助细胞淋巴瘤(血管免疫母细胞型)的病例。我们怀疑阿达木单抗、甲氨蝶呤、Epstein-Barr病毒(EBV)再活化、先前的反应性淋巴细胞增生和银屑病本身都使患者容易患淋巴瘤,而两剂mRNA疫苗则是最后一根稻草。
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来源期刊
Indian Journal of Dermatology
Indian Journal of Dermatology Medicine-Dermatology
CiteScore
1.80
自引率
0.00%
发文量
217
审稿时长
47 weeks
期刊介绍: The journal publishes information related to skin-pathology and different modes of therapeutics, including dermatosurgery and cosmetic dermatology. Likewise, it carries articles on leprosy, STI and HIV/AIDS. The editorial board encourages the authors to publish articles addressing emerging techniques and developments in the subject specialty, in the form of Original investigations, Narrative and Systematic Reviews as well as Case Reports. The journal aims at publishing Editorials and Commentaries from eminent personalities on a regular basis.
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