Development of pancytopenia after single low-dose methotrexate therapy in patients with chronic kidney disease: a review of the literature

Authors : İbrahim AKDAĞ, Alparslan ERSOY

Pages : 83-90

Doi:10.46310/tjim.766086

View : 15 | Download : 10

Publication Date : 2020-07-29

Article Type : Other Papers

Abstract :Methotrexate insert ignore into journalissuearticles values(MTX); is widely used in the treatment of both rheumatoid arthritis insert ignore into journalissuearticles values(RA); and psoriatic arthritis insert ignore into journalissuearticles values(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 : Chronic kidney disease, methotrexate, psoriatic arthritis, rheumatoid arthritis, pancytopenia