Development of pancytopenia after single low-dose methotrexate therapy in patients with chronic kidney disease: a review of the literature
Open Access
- 29 July 2020
- journal article
- review article
- Published by Turkish Journal of Internal Medicine in Turkish Journal of Internal Medicine
- Vol. 2 (3), 83-90
- https://doi.org/10.46310/tjim.766086
Abstract
Methotrexate (MTX) is widely used in the treatment of both rheumatoid arthritis (RA) and psoriatic arthritis (PA) with a side effect of pancytopenia. However, very few cases of severe pancytopenia caused by low-dose MTX therapy have been described in chronic kidney disease. Pancytopenia occurred after using a single dose of MTX in three patients with chronic kidney dysfunction. While one patient died due to sepsis and multiple organ failure, the others recovered. The severity of MTX-inducedpancytopenia in our cases was likely related to the underlyingkidney disease. These cases suggest that uremic patients may develop severe fatal bone marrow toxicity even with a single dose of MTX. Therefore, close blood count monitoring after MTX treatment in this population would be beneficial.Keywords
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