Early-onset pancytopenia and skin ulcer following low-dose methotrexate therapy

Human and Experimental Toxicology

Volumn 27, Issue 7, 2008, Pages 585-589

  Hocaoglu, N ^a   Atilla, R ^a   Onen, F ^a   Tuncok, Y ^a  

^a DOKUZ EYLUL UNIVERSITY   (Turkey)

Author keywords

Low dose methotrexate therapy; Pancytopenia; Skin ulcer

Indexed keywords

CEFEPIME; CIPROFLOXACIN; FOLINIC ACID; FRESH FROZEN PLASMA; METHOTREXATE; PARACETAMOL; ANTIINFECTIVE AGENT; ANTIRHEUMATIC AGENT; VITAMIN B COMPLEX;

ADULT; APPETITE DISORDER; ARTICLE; BLOOD CLOT; BLOOD CLOTTING; CASE REPORT; DRUG BLOOD LEVEL; DRUG WITHDRAWAL; EMERGENCY CARE; ERYTHROCYTE TRANSFUSION; FEVER; FOOT ULCER; HUMAN; MALE; MEDICATION ERROR; MOUTH PAIN; MOUTH ULCER; NAUSEA; PANCYTOPENIA; PLASMA TRANSFUSION; PRIORITY JOURNAL; RECOMMENDED DRUG DOSE; SKIN ULCER; TREATMENT DURATION; VOMITING; WEAKNESS; BLOOD TRANSFUSION; CHEMICALLY INDUCED DISORDER; DOSE RESPONSE; INTRAVENOUS DRUG ADMINISTRATION; MIDDLE AGED; PATHOLOGY;

ANTI-BACTERIAL AGENTS; ANTIRHEUMATIC AGENTS; BLOOD TRANSFUSION; DOSE-RESPONSE RELATIONSHIP, DRUG; HUMANS; INJECTIONS, INTRAVENOUS; LEUCOVORIN; MALE; METHOTREXATE; MIDDLE AGED; PANCYTOPENIA; SKIN ULCER; VITAMIN B COMPLEX;

EID: 56049123411     PISSN: 09603271     EISSN: None     Source Type: Journal    
DOI: 10.1177/0960327108094507     Document Type: Article

References (27)

1. Mohr K Herzig S. Methotrexat. Dtsch Med Wschr 2000 ; 125: 1435 - 1436.
2. Leeb BF Smolen JS. Low-dose methotrexate therapy in chronic polyarthritis-an update. Acta Med Austriaca 1996 ; 23: 114 - 119.
3. Nordstrom DM West SG Andersen PA Sharp JT. Pulse methotrexate therapy in rheumatoid arthritis: a controlled prospective roentgenographic study. Ann Intern Med 1987 ; 107: 797 - 801.
4. Williams HJ Willkens RF Samuelson CO Alarcón GS Guttadauria M Yarboro C. Comparison of low-dose oral pulse methotrexate and placebo in the treatment of rheumatoid arthritis. Arthritis Rheum 1985 ; 28: 721 - 730.
5. Weinblatt ME. Toxicity of low dose methotrexate in rheumatoid arthritis. J Rheumatol 1985 ; 12: 35 - 39.
6. Landewe RB van den Borne BE Breedweld FC Dijkmans BA. Methotrexate effects in patients with rheumatoid arthritis with cardiovascular comorbidity. Lancet 2000 ; 355: 1616 - 1617.
7. Doolittle GC Simpson KM Lindsley HB. Methotrexate-associated, early-onset pancytopenia in rheumatoid arthritis. Arch Intern Med 1989 ; 149: 1430 - 1431.
8. Montero LC Gomez RS Bernaldo de Quiros JF. (letter) Cutaneous ulcerations in a patient with rheumatoid arthritis receiving treatment with methotrexate. J Rheumatol 2000 ; 27: 2290 - 2291.
9. Calvo-Romero JM. Severe pancytopenia associated with low-dose methotrexate therapy for rheumatoid arthritis. Ann Pharmacother 2001 ; 35: 1575 - 1577.
10. Shupack JL Webster GF. Pancytopenia following low-dose oral methotrexate therapy for psoriasis. JAMA 1988 ; 259: 3594 - 3596.
11. Arnett FC Edworthy SM Bloch DA McShane DJ Fries JF Cooper NS. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988 ; 31: 315 - 324.
12. Grove ML Hassell AB Hay EM Shadforth MF. Adverse reactions to disease-modifying anti-rheumatic drugs in clinical practice. QJM 2001 ; 94: 309 - 319.
13. Brown MA Corrigan ABcGuigan MA. Pancytopenia after accidental overdose of methotrexate. A complication of low-dose therapy for rheumatoid arthritis. Med J Aust 1991 ; 155: 493 - 494.
14. Cohen PR Schulze KE Nelson BR. Pancytopenia after a single intradermal infiltration of methotrexate. J Drugs Dermatol 2005 ; 4: 648 - 651.
15. Kuitunen T Malmstrom J Palva E Pettersson T. Pancytopenia induced by low-dose methotrexate. A study of the cases reported to the Finnish Adverse Drug Reaction Register From 1991 to 1999. Scand J Rheumatol 2005 ; 34: 238 - 241.
16. Bologna C Viu P Jorgensen C Sany J. Effect of age on the efficacy and tolerance of methotrexate in rheumatoid arthritis. Br J Rheumatol 1996 ; 35: 453 - 457.
17. Hirshberg B Muszkat M Schlesinger O Rubinow A. Safety of low dose methotrexate in elderly patients with rheumatoid arthritis. Postgrad Med J 2000 ; 76: 787 - 789.
18. Rheumatoid Arthritis Clinical Trial Archive Group. The effect of age and renal function on the efficacy and toxicity of methotrexate in rheumatoid arthritis. J Rheumatol 1995 ; 22: 218 - 223.
19. Moisa A Fritz P Benz D Wehner HD. Iatrogenically-related, fatal methotrexate intoxication: a series of four cases. Forensic Sci Int 2006 ; 156: 154 - 157.
20. Izzedine H Launay-Vacher V Karie S Caramella C de Person F Deray G. Is low-dose methotrexate nephrotoxic? Case report and review of the literature. Clin Nephrol 2005 ; 64: 315 - 319.
21. Suzuki Y Uehara R Tajima C Noguchi A Ide M Ichikawa Y. Elevation of serum hepatic aminotransferases during treatment of rheumatoid arthritis with low-dose methotrexate. Scand J Rheumatol 1999 ; 28: 273 - 281.
22. Knowles SR Uetrecht J Shear NH. Idiosyncratic drug reactions: the reactive metabolite syndromes. Lancet 2000 ; 356: 1587 - 1591.
23. Gutierrez-Urena S Molina JF García CO Cuéllar ML Espinoza LR. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum 1996 ; 39: 272 - 276.
24. Adverse drug reactions advisory committee. Low dose methotrexate therapy-toxic if not taken correctly. Med J Aust 1994 ; 161: 152.
25. Del Pozo J Martínez W García-Silva J Almagro M Peña-Penabad C Fonseca E. Cutaneous ulceration as a sign of methotrexate toxicity. Eur J Dermatol 2001 ; 11: 450 - 452.
26. Ben-Amitai D Hodak E David M. Cutaneous ulceration: an unusual sign of methotrexate toxicity-first report in a patient without psoriasis. Ann Pharmacother 1998 ; 32: 651 - 653.
27. Naranjo CA. Naranjo ADR Probability Scale. Clin Pharmacol Ther 1981 ; 30: 239 - 245.