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Low-dose methotrexate-induced pancytopenia.

Yogesh Preet Singh1, Amita Aggarwal, Ramnath Misra

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

Clinical Rheumatology
|April 26, 2006
PubMed
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Methotrexate (MTX) can cause severe pancytopenia, a dangerous drop in blood cells, even leading to death. Increased awareness among doctors, patients, and pharmacists is crucial to prevent these serious MTX complications.

Area of Science:

  • Rheumatology
  • Hematology
  • Clinical Pharmacology

Background:

  • Methotrexate (MTX) is a widely used disease-modifying antirheumatic drug (DMARD) for inflammatory rheumatological conditions.
  • Despite its efficacy and generally safe profile, MTX carries a risk of severe, potentially fatal adverse events.
  • MTX-induced pancytopenia is a rare but critical complication.

Purpose of the Study:

  • To report a series of patients who developed serious pancytopenia after MTX use.
  • To analyze the clinical, laboratory, and outcome data of these cases.
  • To highlight the need for improved awareness and monitoring of MTX therapy.

Main Methods:

  • Retrospective case series review of five patients treated with MTX.
  • Analysis of clinical presentation, laboratory findings, and patient outcomes.

Related Experiment Videos

  • Literature review on MTX-induced pancytopenia.

    • Main Results:

    • Five patients developed serious pancytopenia attributed to MTX.
    • One patient died as a consequence of MTX-induced pancytopenia.
    • Two cases arose from prescription errors by primary care physicians.

    Conclusions:

    • Methotrexate-induced pancytopenia is a serious, life-threatening complication that requires vigilant monitoring.
    • Prescription errors contribute to MTX-related adverse events.
    • Enhanced education for primary care physicians, patients, and pharmacists is essential for safe MTX prescribing, dispensing, and monitoring.