alexa Abstract | Follow-Up Study of Epstein-Barr Virus-Associated Hodgkin's Lymphoma (HL) Developed in a Patient with Rheumatoid Arthritis (RA) and Analysis of Circulating Cytokines and Clinical Parameters: Clarithromycin Coupled with Prednisolone is Effective for Preventing Relapse of HL and Controlling RA

Archives of Clinical Microbiology
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Case Report Open Access


We conducted a follow-up study of Epstein-Barr virus (EBV)-associated Hodgkin’s Lymphoma (HL) in a patient with rheumatoid arthritis (RA) in whom a drastic complete remission (CR) was achieved after withdrawing methotrexate (MTX) together with administration of clarithromycin (CAM). CAM was administered for 1 year after the first admission but typical HL relapsed 4 months after suspending CAM treatment. The relapse was successfully treated with standard chemotherapy and led to CR. After achieving CR, treatment of CAM coupled with low-dose prednisolone (PSL) was restarted as a maintenance therapy. This combination treatment was found to be effective for preventing the relapse as well as controlling RA. Neither MTX nor other anti-rheumatic drugs except for PSL have been used since initial presentation. To date, no relapse has occurred and RA symptoms are fairly well controlled. Clinical parameters for EBV, RA and HL and circulating cytokines during the course of illness showed elevated levels of soluble interleukin-2 receptors, interleukin (IL)-1β, IL-6 and tumor necrosis factor-α in initial phase of the disease as well as in relapse phase, and returned to normal in CR phase. Copies of EBV-DNA in circulating lymphocytes were increased in relapse phase but returned to normal in CR phase. Since relapse occurred without MTX, this drug is thought not to have caused the HL. Rather, immunodeficiency due to RA itself or PSL (more than 10mg/day) administration might have resulted in reactivation of EBV, leading to HL. Immunomodulatory and immunosuppressive effects of CAM coupled with low-dose PSL on cytokine networks might be involved in maintaining CR and controlling RA. This combination treatment is recommended as a maintenance treatment from the perspective of simplicity, safety and cost-effectiveness in such a situation.

To read the full article Peer-reviewed Article PDF image | Peer-reviewed Full Article image

Author(s): Nobuo Takemori Hiroyuki Kaneko Toshio Fukuda and Masaru Kojima


Hodgkina's lymphoma, RA, EB-virus, Clarithromycin, Prednisolone, CR, Cytokine, Treatment, Hodgkina's lymphoma, RA, EB-virus, Clarithromycin, Prednisolone, CR, Cytokine, Treatment

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us