Reversible lymphoproliferative disorder in systemic lupus erythematosus treated with mycophenolate mofetil: A case report and literature review

Abstract

Background

Mycophenolate mofetil (MMF) is widely used to treat systemic lupus erythematosus (SLE), particularly in cases with severe and organ-threatening complications such as lupus nephritis. However, multiple reports have documented lymphoproliferative disorder (LPD) in patients with SLE undergoing MMF therapy, predominantly developing in the central nervous system and requiring aggressive treatment, including chemotherapy, radiation, and surgery.

Case Report

We herein report the case of a 58-year-old female patient with SLE who developed cervical, hepatic hilar, and para-aortic lymphadenopathy 8 years after initiating MMF treatment. Histopathological examination of the left cervical lymph node revealed features consistent with polymorphic LPD. MMF was discontinued, and after 2 months of surveillance, the enlarged lymph nodes regressed without need for additional treatment.

Conclusion

To the best of our knowledge, this is the first reported case of MMF-associated LPD occurring outside the central nervous system in a patient with SLE, which resolved spontaneously upon MMF withdrawal. Clinicians should remain vigilant regarding the possibility of MMF-associated LPD when administering MMF to patients with SLE.