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Concurrent acute megaloblastic anaemia and pneumonitis : A severe side-effect of low-dose methotrexate therapy during rheumatoid arthritis

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Summary

In a patient suffering from rheumatoid arthritis, we report the first simultaneous occurrence of two side effects of low-dose methotrexate : an acute megaloblastic anaemia and a pneumonitis. A combination of methotrexate suspension, folinic acid and corticosteroids led to recovery. The correlation between the haematologic and pneumologic toxicity is discussed.

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References

  1. Scully, C.J., Anderson, C.J., Cannon, G.W. Long-term methotrexate therapy for rheumatoid arthritis. Semin Arthritis Rheum 1991, 20, 317–331.

    PubMed  Google Scholar 

  2. Weinblatt, M.E., Fraser, P. Elevated mean corpuscular volume as a predictor of hematologic toxicity due to methotrexate therapy. Arthritis Rheum 1989, 32, 1592–1596.

    PubMed  Google Scholar 

  3. Clamon, G.H., Feld, R., Evans, W.K., Weiner, R.S., Kramer, B.S., Lininge, L.L., Gardner, L.B., Wolfe, E.C., Dewys, W.D., Hoffman, F.A. Serum folate and vitamin B 12 levels in patients with small lung cancer. Cancer 1984, 53, 306–310.

    PubMed  Google Scholar 

  4. Ames, B.N., Gold, L.S. Endogenous mutagens and the causes of aging and cancer. Mutat Res 1991, 250, 3–16.

    PubMed  Google Scholar 

  5. Stewart, K.A., Mackenzie, A.H., Clough, J.D., Wilke, W.S. Folate supplementation in methotrexate-treated rheumatoid arthritis. Semin Arthritis Rheum 1991, 20, 332–338.

    PubMed  Google Scholar 

  6. Cohen, O., Leibovici, L., Wysenveck, A.I. Carcinoma of the prostate presenting as interstital lung disease. Respiration 1987, 51, 158–160.

    PubMed  Google Scholar 

  7. Segal, P., Yaron, M., Tartakowsky, B. Methotrexate: Mechanism of action in rheumatoid arthritis. Semin Arthritis Rheum 1990, 20, 190–199.

    PubMed  Google Scholar 

  8. Cook, N.J., Caroll, G.J. Successful reintroduction of methotrexate after pneumonitis in two patients with rheumatoid arthritis. Ann Rheum Dis 1992, 51, 272–274.

    PubMed  Google Scholar 

  9. Morgan, S.L., Bagott, J.E., Vaughn, W.H. The effect of folic acid supplementation on the toxicity of low-dose methotrexate in patients with rheumatoid arthritis. Arthritis Rheum 1990, 33, 9–18.

    PubMed  Google Scholar 

  10. Joyce, D.A., Will, R.K., Hoffman, D.M., Laing, B., Blackbourn, S.J. Exacerbation of rheumatoid arthritis in patients treated with methotrexate after administration of folinic acid. Ann Rheum Dis 1991, 50, 913–914.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de Medecine Interne du Professeur P.J. WEILLER, Centre Hospitalo-Universitaire de la Timone, Marseille, France

    G. Bolla M.D., P. Disdier, J. R. Harle, D. Verrot & P. J. Weiller

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  1. G. Bolla M.D.
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  2. P. Disdier
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  3. J. R. Harle
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  4. D. Verrot
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  5. P. J. Weiller
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Bolla, G., Disdier, P., Harle, J.R. et al. Concurrent acute megaloblastic anaemia and pneumonitis : A severe side-effect of low-dose methotrexate therapy during rheumatoid arthritis. Clin Rheumatol 12, 535–537 (1993). https://doi.org/10.1007/BF02231787

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  • DOI: https://doi.org/10.1007/BF02231787

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