Rheumatoid Arthritis: An Exceptional Complication of Chemotherapy in a Patient with Lung Cancer

Tse-Hao Lee¹, Rong-Hsin Yang¹ and Yum-Kung Chu^{1, 2,}

¹Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan

²National Yang-Ming University School of Medicine, Taiwan;National Defense Medical Center, Taipei, Taiwan

Cite this paper

Tse-Hao Lee, Rong-Hsin Yang and Yum-Kung Chu. Rheumatoid Arthritis: An Exceptional Complication of Chemotherapy in a Patient with Lung Cancer. American Journal of Medical Case Reports. 2015; 3(5):130-132. doi: 10.12691/AJMCR-3-5-3

Abstract

A 63-year-old non-smoker, without previous history of arthritis, developed inflammatory arthritis while being treated with pemetrexed/cisplatin combination for advanced lung cancer. Clinical features and serology fulfilled the 2010 ACR/EULAR criteria for the diagnosis of rheumatoid arthritis (RA). RA is an autoimmune disease that primarily attacks joint tissues, causing inflammation of the joint lining. Although the relationship between these anticancer agents and the presence of RA remains unclear, this unprecedented adverse effect can be corrected by changing therapeutic strategies. Our case report might open a medical debate about chemotherapy side effect in cancer patients.

Keywords

anti-cyclic citrullinated peptide, autoimmunity, pemetrexed, rheumatoid arthritis

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62;(9):2569-2581.
[2]	Firestein GS. Etiology and pathogenesis of rheumatoid arthritis. In: Ruddy S, Harris E, Sledge C, eds. Kelly's Textbook of Rheumatology, 6th ed. Philadelphia: WB Saunders, 2001, 921-966.
[3]	Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31(3):315-324.
[4]	Hitchon CA, El-Gabalawy HS. The synovium in rheumatoid arthritis. Open Rheumatol 2011; 5(suppl 1):107-114.
[5]	Smolen JS, Steiner G. Therapeutic strategies for rheumatoid arthritis. Nat Rev Drug Discov 2003; 2(6):473-488.
[6]	Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis and rheumatism 2008; 59(6):762-84.
[7]	Okamoto I, Aoe K, Kato T, Hosomi Y, Yokoyama A, et al. Pemetrexed and carboplatin followed by pemetrexed maintenance therapy in chemo-naive patients with advanced nonsquamous non-small-cell lung cancer. Invest New Drugs 2013; 31(5): 1275-1282.
[8]	Bucala R, Ritchlin C, Winchester R, Ceram A. Constitutive production of inflammatory and mitogenic cytokines by rheumatoid synovial fibroblasts. J Exp Med 1991; 173(3): 569-574.
[9]	Van der Heijden JW, Oerlemans R, Dijkmans BA, Qi H, van der Laken CJ, et al. Folate receptor beta as a potential delivery route for novel folate antagonists to macrophages in the synovial tissue of rheumatoid arthritis patients. Arthritis Rheum 2009; 60(1):12-21.
[10]	Lories RJU, Derese I, De Bari C, Luyten FP. In vitro growth rate of fibroblast-like synovial cells is reduced by methotrexate treatment. Ann Rheum Dis 2003; 62(6):568-571.
[11]	Nakazawa F, Matsuno H, Yudoh K, Katayama R, Sawai T, et al. Methotrexate inhibits rheumatoid synovitis by inducing apoptosis. J Rheumatol 2001; 28(8):1800-1808.
[12]	Meyer FA, Yaron I, Mashiah V, Yaron M. Methotrexate inhibits proliferation but not interleukin 1 stimulated secretory activities of cultured human synovial fibroblasts. J Rheumatol 1993; 20(2):238-242.
[13]	Gray O, McDonnell GV, Forbes RB. Methotrexate for multiple sclerosis. Cochrane Database Syst Rev 2004 Apr 19; (2): CD003208. Review.
[14]	McDonald JW, Tsoulis DJ, Macdonald JK, Feagan BG. Methotrexate for induction of remission in refractory Crohn's disease. Cochrane Database Syst Rev 2012 Dec 12; (12): CD003459.
[15]	Wong JM, Esdaile JM. Methotrexate in systemic lupus erythematosus. Lupus 2005; 14(2), 101-105.