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Pancytopenia as a Complication of Low-Dose Methotrexate in a Septuagenarian: A Rare Presentation
Journal article   Open access   Peer reviewed

Pancytopenia as a Complication of Low-Dose Methotrexate in a Septuagenarian: A Rare Presentation

CUREUS JOURNAL OF MEDICAL SCIENCE, v 12(6), e8492
07 Jun 2020
PMID: 32656010
url
https://doi.org/10.7759/cureus.8492View
Published, Version of Record (VoR) Open

Abstract

Methotrexate (MTX) is an antimetabolite that was initially developed as a chemotherapeutic agent to treat malignancies but later used extensively to treat rheumatological conditions. MTX-induced toxicity is dose- and duration-dependent. Myelosuppression is a rare but fatal complication of MTX that can occur even with low doses used for inflammatory conditions. Multiple factors such as age, renal impairment, and nutritional status increase the risk of developing MTX toxicity. Frequent monitoring of symptoms and lab values are the hallmarks of prompt diagnosis and prevention of complications. Clinicians should have a high degree of suspicion to diagnose pancytopenia secondary to MTX especially in patients with multiple confounding comorbidities. We present the case of a 79-year-old male who presented with mucositis and pancytopenia diagnosed to be secondary to weekly MTX for giant cell arteritis leading to anemia and septic shock causing death.

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Collaboration types
Domestic collaboration
Web of Science research areas
Rheumatology
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