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oxicam 15 mg/day for 21 months, showing little inflammatory activity of the RA when she complained about impaired nasal breathing and a tumour-like lesion of the nasal wing. Computed tomography showed a mass in the nasal septum (fig. 1). Histologic examination revealed LYG II°. EBV-nuclear-IgG and EBV-capsid-IgG were positive whereas EBV-capsid-IgM was negative, consistent with prior but not acute EBV infection. MTX was discontinued immediately. Since IFN-α has been implicated in the activation of arthritis [7], we felt reluctant to its use. However, CHOP seemed too aggressive in this elderly patient with low-grade LYG. Because of its effectiveness in the treatment of B cell lymphoma as well as RA, we decided to give 4 doses of mabthera 375 mg/m weekly. Complete remission (CR) of LYG was confirmed 4 weeks after the last dose. 19 months later, the patient was in ongoing CR of LYG and shows no clinical signs of active RA under sulfasalazine 2000 mg/day.

Band 20, Heft 6, Dezember 2013 / Vol. 20, Issue 6, December 2013