METHOTREXATE TOXICITY AS MYELOSUPPRESSION IN 66-YEAR-OLD FEMALE WITH RHEUMATOID ARTHRITIS IN CHENNAI, TAMIL NADU, INDIA

Methotrexate can cause a range of toxicities. It is usually not life threatening in low dose even when taken for long term. Life threatening complications are usually seen in high dose methotrexate therapy which could even lead to malignancies. Life threatening complications and adverse effects can be seen at any dose except for nephrotoxicity which is most commonly seen in high dose methotrexate treatment. This case report deals with a case of rheumatoid arthritis on long term methotrexate therapy, who unknowingly took excessive dosage of methotrexate leading to myelosuppression. Patient was treated with folinic acid (leucovorin) rescue, G-CSF and a prolonged isolation following which patient improved.