AI Summary & Key Takeaways
AI InsightIn this article, we reported a patient taking low-dose oral MTX for 9 months because of the diagnosis of psoriatic arthritis in whom pancytopenia, delirium, fever, and gastrointestinal side-effects developed and then all of the findings disappeared after MTX is ceased and folinic acid rescue treatment was performed.
📌 3 Key Takeaways
Abstract
Methotrexate (MTX) is a folic acid antagonist that limits the amount of tetrahydrofolate which is required in the synthesis of purine. In general, high dose MTX is used in leukemias and lymphomas while a low dose is used in the treatment of some rheumatic diseases for immunosuppressive purpose. The side effects caused by high doses of MTX are less common in low doses. Known side effects are bone marrow suppression, oral and gastrointestinal ulcers, hepatotoxicity, and pulmonary fibrosis. In this article, we reported a patient taking low-dose oral MTX for 9 months because of the diagnosis of psoriatic arthritis in whom pancytopenia, delirium, fever, and gastrointestinal side-effects developed and then all of the findings disappeared after MTX is ceased and folinic acid rescue treatment was performed.
Özet
Metotreksat (MTX) purin sentezinde gerekli olan tetrahidrofolat miktarını sınırlandıran bir folik asit antagonistidir. Genellikle MTX'in yüksek dozları lösemi ve lenfomalarda kullanılırken düşük dozları bazı romatolojik hastalıkların tedavisinde immünsupresif amaçla kullanılmaktadır. Yüksek dozda MTX'a bağlı ortaya çıkan yan etkiler, düşük dozlarda daha az görülmektedir. Bilinen yan etkileri; kemik iliği supresyonu, oral ve gastrointestinal sistem ülserleri, hepatotoksisite ve pulmoner fibrozistir. Bu makalede psöriatik artrit tanısı ile 9 ay önce düşük doz oral MTX başlanan ve sonrasında pansitopeni, deliryum, ateş, gastrointestinal yan etkiler gelişen, MTX kesilip folinik asit kurtarma tedavisi uygulanınca tüm bulguları kaybolan bir olgu sunulmuştur.