Methotrexate Toxicity Management in Polymyalgia Rheumatica: A Case Report.

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.55729/2000-9666.1531

Devi M Kotharu, Sai D Vutukuru, Prafullkumar Patel, Athmananda Nanjundappa, Sumanth K Bandaru

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引用次数: 0

Abstract

Methotrexate (MTX) is an anti-folate drug with anti-inflammatory and anti-proliferative properties. Low-dose methotrexate (10-25 mg/week) is widely recognized as a safe and effective treatment for various autoimmune disorders. While toxicity from low dose methotrexate is uncommon it can lead to severe complications like pancytopenia. We present a case of a 68-year-old male with a history of steroid-resistant Polymyalgia Rheumatica on methotrexate (20 mg weekly) and prednisone. He presented to the emergency room with oral mucosal lesions and reduced oral intake. Upon evaluation, he was found to have pancytopenia and transaminitis, raising concern for methotrexate toxicity. Treatment included folinic acid rescue therapy and filgrastim. This case highlights the importance of promptly identifying signs of methotrexate toxicity and regularly monitoring patients for adverse effects by healthcare providers.

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甲氨蝶呤对风湿性多肌痛的毒性管理：1例报告。

甲氨蝶呤（MTX）是一种抗叶酸药物，具有抗炎和抗增殖的特性。低剂量甲氨蝶呤（10- 25mg /周）被广泛认为是一种安全有效的治疗各种自身免疫性疾病的方法。虽然低剂量甲氨蝶呤的毒性并不常见，但它可能导致严重的并发症，如全血细胞减少症。我们提出一个68岁的男性与类固醇抵抗多肌痛风湿病史甲氨蝶呤（每周20毫克）和强的松。他因口腔黏膜病变和口服摄入量减少而被送往急诊室。经检查，发现他有全细胞减少症和转氨炎，引起对甲氨蝶呤毒性的关注。治疗包括亚叶酸抢救治疗和非格拉西汀。本病例强调了及时识别甲氨蝶呤毒性迹象和医疗保健提供者定期监测患者不良反应的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Community Hospital Internal Medicine Perspectives MEDICINE, GENERAL & INTERNAL-

自引率

0.00%

发文量

106

审稿时长

17 weeks

期刊介绍： JCHIMP provides: up-to-date information in the field of Internal Medicine to community hospital medical professionals a platform for clinical faculty, residents, and medical students to publish research relevant to community hospital programs. Manuscripts that explore aspects of medicine at community hospitals welcome, including but not limited to: the best practices of community academic programs community hospital-based research opinion and insight from community hospital leadership and faculty the scholarly work of residents and medical students affiliated with community hospitals.