A case of Severe Low-dose Methotrexate-induced Toxicity
Journal Title: HASEKİ TIP BÜLTENİ - Year 2016, Vol 54, Issue 4
Abstract
Methotrexate (MTX) is an antimetabolite which competitively inhibits dihydrofolic acid reductase; inhibits purine and thymidylic acid synthesis, which in turn interferes with DNA synthesis, repair, and cellular replication. MTX is a good treatment option for neoplastic, rheumatic and dermatological diseases. However, rarely, may cause side effects, such as agranulocytosis and bone marrow suppression, mucosal tissue inflammation and necrotic changes, liver cell necrosis and hepatic cirrhosis, pulmonary fibrosis, and severe renal dysfunction. Herein, we report a 67-year-old female patient with a history of psoriasis for 15 years and MTX 15 mg/sc/week use for 8 years who was admitted due to the complaints of pancytopenia, mucositis and ulcers on psoriatic plaques despite low-dose MTX use. We present this case to remind that MTX toxicity might occur with low-dose MTX usage and to draw attention to various factors that facilitate the low-dose MTX toxicity, such as age, renal insufficiency, low albumin levels, infections, proton pump inhibitors and non-steroidal anti-inflammatory drugs.
Authors and Affiliations
Filiz Topaloğlu Demir, Yavuz Tezcan, Zafer Türkoğlu, Şerife Başaran
Keywords
Related Articles
- EP ID EP227919
- DOI 10.4274/haseki.3202
- Views 82
- Downloads 0
Multiseptate Gallbladder, a Rare Cause of Recurrent Abdominal Pain: A Case Report and Review of the Literature
Multiseptate gallbladder is a rare congenital malformation. It was first described by Simon and Tandon in 1963. A 1-year-old boy was admitted to our clinic with the complaints of intermittent abdominal pain and itching....
Safety Surgery in Laparoscopıc Cholesistectomy
Bile duct injuries are the most frightening complications in laparoscopic cholecystectomy surgery. It is thought that incomplete surgical field dissection causes these situations. In this case, cholelithiasis and minimal...
Effects of Preoperative Anxiety and General Anesthetic Administration on Intraoperative Awareness in Patients Undergoing Cesarean Section
Aim: The aim was to investigate the effects of preoperative anxiety and general anesthetic administrations on intraoperative awareness among patients undergoing cesarean section. Methods: This prospective randomized stud...
Extrapulmonary Tuberculosis: Two Case Reports
Mycobacterium tuberculosis is still a major public health problem today, especially in developing countries. Tuberculosis is a disease that can involve every organ, especially the lungs, and the emergence of different sy...
Evaluation of Optokinetic Nystagmus Asymmetry in Surgically Treated Infantile Esotropia Patients
Aim: To evaluate the relationship between binocularity and optokinetic nystagmus asymmetry (OKN) in patients with infantile esotropia. Methods: The study design was prospective and cross-sectional. Ten patients who under...