Korean J Med.  2009 Nov;77(5):637-642.

Low-dose methotrexate-induced pancytopenia in three patients with impaired renal function

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Colleage of Medicine, Seoul, Korea. yangch@catholic.ac.kr

Abstract

Methotrexate (MTX) is indicated for patients with moderate to severe rheumatoid arthritis (RA), but it sometimes causes severe hematologic complications in patients with impaired renal function. We experienced three cases of pancytopenia due to low-dose MTX treatment in RA patients with impaired renal function. Two patients were dialysis patients, and the other had stage 4 chronic kidney disease. The mean cumulative MTX dose and treatment duration for the three patients was 25 mg and 10 days, respectively. All cases experienced severe stomatitis and pancytopenia and recovered with conservative care. In conclusion, MTX should be used cautiously in patients with impaired renal function.

Keyword

Methotrexate; Impaired renal function; Pancytopenia

MeSH Terms

Arthritis, Rheumatoid
Dialysis
Humans
Methotrexate
Pancytopenia
Renal Insufficiency, Chronic
Stomatitis
Methotrexate
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