Rare case of iatrogenic immunodeficiency associated lymphoproliferative disorder with superimposed infection causing airway obstruction requiring emergent tracheostomy

Natalie Derise, MD; Anatoli Karas, MD; Ryan Marshall, MD; Nicholas Smith, MD

Otolaryngology Case Reports (Nov 2021)

Rare case of iatrogenic immunodeficiency associated lymphoproliferative disorder with superimposed infection causing airway obstruction requiring emergent tracheostomy

Natalie Derise, MD,
Anatoli Karas, MD,
Ryan Marshall, MD,
Nicholas Smith, MD

Affiliations

Natalie Derise, MD: University of Alabama at Birmingham Department of Otolaryngology Head and Neck Surgery, FOT 1155, 1720 2nd Avenue, South Birmingham, AL, 35294-3412, USA; Corresponding author. FOT 1155, 1720 2nd Avenue South Birmingham, AL, 35294-3412, USA.
Anatoli Karas, MD: University of Alabama at Birmingham Children's of Alabama Department of Otolaryngology, FOT 1155, 1720 2nd Avenue, South Birmingham, AL, 35294-3412, USA
Ryan Marshall, MD: University of Alabama at Birmingham Department of Otolaryngology Head and Neck Surgery, FOT 1155, 1720 2nd Avenue, South Birmingham, AL, 35294-3412, USA
Nicholas Smith, MD: University of Alabama at Birmingham Children's of Alabama Department of Otolaryngology, FOT 1155, 1720 2nd Avenue, South Birmingham, AL, 35294-3412, USA

Journal volume & issue: Vol. 21
p. 100333

Abstract

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Methotrexate is an immunomodulator used as first line treatment for patients with rheumatoid arthritis and has a well-recognized association with other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD). OIIA-LPD and its association with methotrexate has been discussed in the literature but is rarely seen in the pediatric population. Additionally, there are no prior reports showing an association between IIA-LPD and bacterial superinfection. We present a case of airway compromise requiring emergent tracheostomy in a 15-year-old patient secondary to superimposed infection in the setting of lymphoproliferative disorder. To our knowledge, this is the first case of OIIA-LPD causing airway compromise requiring emergent tracheostomy.

Published in Otolaryngology Case Reports

ISSN: 2468-5488 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Otorhinolaryngology
Website: https://www.journals.elsevier.com/otolaryngology-case-reports/

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