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From Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy in Erie, Pa (Dr Sliesoraitis); from LECOM in Bradenton, Fla, where Dr Khan was a student at the time of this report; and from the Regional Cancer Center in Erie, Pa (Dr Rothman). Dr Sliesoraitis was an osteopathic medical student at the time of this report.

Address correspondence to Sarunas Sliesoraitis, PharmD, DO, Assistant Professor of Pharmacy Practice, LECOM School of Pharmacy, 1858 W Grandview Blvd, Erie, PA 16509-1025. E-mail: ssliesoraitis{at}lecom.edu

Methotrexate sodium use in the management of various immunologic disorders has increased—as have the number of reported adverse effects associated with this therapy. While methotrexate has helped combat various autoimmune and cancerous disorders, the paradoxical risk of causing an often fatal malignancy may still occur as a result of the drug's effect on suppressing immune function. We present a case of methotrexate-induced Hodgkin disease in a 48-year-old man with a history of systemic lupus erythematosus (SLE). Discontinuation of methotrexate facilitated Hodgkin disease reversal. In addition, we review other lymphoproliferative hematologic malignancies caused by methotrexate.