DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20171122

A case report on methotrexate induced pancytopenia

Meghana Devulapallli, T. S. Durga Prasad, G. V. Narasimha Kumar, B. Avanthi, S. K. Shabana Banu

Abstract


Systemic lupus erythematosus (SLE) is a non-specific systemic inflammatory disease that affects various organ systems in the body leading to a wide spectrum of clinical presentations. The management of SLE includes therapy with immunosuppressant agents who have a narrow safety range and a wide adverse effect profile. Methotrexate discussed in this case report is one of such drugs whose short term and long term usage has been associated with various adverse events that affect the individuals quality of life. So, it is always advisable to take prophylactic measures and to provide patient education to detect and prevent adverse events at the earliest.


Keywords


Adverse drug reaction, Drug induced pancytopenia, Drug related morbidity, Impaired quality of life

Full Text:

PDF

References


Henghe T, Bruce NC. Understanding the Mechanisms of Action of Methotrexate Implications for the Treatment of Rheumatoid Arthritis. Bulletin of the NYU Hospital for Joint Diseases. 2007;65(3):168-73.

Wong JM, Esdaile JM. Methotrexate in systemic lupus erythematosus. Lupus. 2005;14:101-5.

Gansauge S, Breitbart A, Rinaldi N, Schwarz-Eywill M. Methotrexate in patients with moderate systemic lupus erythematosus (exclusion of renal and central nervous system disease). Annals of Rheumatic diseases. 1997;56:382-5.

Md. Nazrul I, Mohsin H, Syed AH, Mohammad NA, Peter MTK, Johannes JR. Efficacy and safety of methotrexate in articular and cutaneous manifestations of systemic lupus erythematosus. International Journal of Rheumatic Diseases. 2012; 15:62-8.

Bertsias G, Ioannidis JPA, Boletis J, Bombardieri S, Cervera R, Dostal C, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis. 2008;67:195-205.

Lim AYN, Gaffney K, Scott DGI. Methotrexate-induced pancytopenia: serious and under-reported? Our experience of 25 cases in 5 years. Rheumatology. 2005;44:1051-5.

Yogesh PS, Amita A, Ramnath M, Vikas A. Low-dose methotrexate-induced pancytopenia. Clinical Rheumatology. 2006;1-7.

Mustafa VD, Tuba OD, Sel├žuk Y, Huseyin Y, Ibrahim T. Pancytopenia Induced by Low Dose Methotrexate. J hum rhythm. 2016;2(2):99-102.

Syed Tanveer AG, Dilshad AK, Farooq AK, Mushtaq A. Adverse Effects of Low Dose Methotrexate in Rheumatoid Arthritis Patients. Journal of the College of Physicians and Surgeons Pakistan. 2012;22(2):101-4.

Mohammad AA, Yongping L, Qiurong Z, Haixia W. Detection of Pancytopenia Associated with Clinical Manifestation and Their Final Diagnosis. Open Journal of Blood Diseases. 2015:5:17-30.

Arvind J, Manjiri N. An etiological reappraisal of pancytopenia- largest series reported to date from a single tertiary care teaching hospital. BMC Hematology. 2013;13:10.

Fernando GI, Sahar EM, Shiri S, Hazem A, Amer KS, Simon B, Valentin M, Mazhar E. Methotrexate Induced Pancytopenia. Case Reports in Rheumatology. 2014;1-4.

Akbar S, Mansoureh S, Navid O. Bone Marrow and Karyotype Findings of Patients with Pancytopenia in Southern Iran. Iran J Med Sci. 2014;39(4):333-340.

Henderson FW, Clyde WA, Collier AM. Laboratory studies in drug-induced pancytopenia. Br Med J. 1980;280:429-30.

Madhuchanda K, Alokendu G. Pancytopenia. JIACM 2002;3(1):29-34.