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Methotrexate induced accelerated nodulosis.

V Agarwal1, Amita Aggarwal, R Misra

  • 1Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

The Journal of the Association of Physicians of India
|January 14, 2005
PubMed
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Methotrexate induced accelerated nodulosis (MIAN) is a rare side effect of methotrexate. This study found no association between MIAN and patient factors or methotrexate dosage, concluding it is a benign condition.

Area of Science:

  • Rheumatology
  • Dermatology
  • Pharmacology

Background:

  • Methotrexate is a common disease-modifying antirheumatic drug.
  • Methotrexate-induced accelerated nodulosis (MIAN) is a rare adverse effect.
  • Limited data exists on MIAN in certain regions.

Purpose of the Study:

  • To analyze cases of MIAN.
  • To investigate associations between MIAN and patient demographics, rheumatoid factor (RF) status, and methotrexate therapy details.
  • To describe clinical presentation and treatment outcomes.

Main Methods:

  • Retrospective analysis of 14 patients diagnosed with MIAN.
  • Data collected on gender, underlying diagnosis (rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis), RF status, and methotrexate dosage and duration.

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  • Clinical presentation, affected sites, and treatment responses were documented.

    • Main Results:

    • 14 patients (8 female) with MIAN were identified, mostly with rheumatoid arthritis.
    • Acute onset of multiple nodules, commonly on the radial border of fingers, was observed.
    • No significant association found between MIAN and gender, RF positivity, disease duration, cumulative methotrexate dose, or therapy duration.
    • Treatments with colchicine, D-penicillamine, or hydroxychloroquine showed no response.

    Conclusions:

    • MIAN is a benign side effect of methotrexate therapy.
    • Clinical characteristics and potential associations were elucidated.
    • Further research may explore underlying mechanisms or management strategies.