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Pericarditis: a rare complication of methotrexate therapy

Tayyab Mohyuddin1, Mazen Elyan1, Irving Kushner2

  • 1MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.

Clinical Rheumatology
|May 24, 2007
PubMed

Insights

Serositis, a rare methotrexate complication, can cause pericarditis. This case report details a rheumatoid arthritis patient who experienced recurrent pericarditis linked to methotrexate, resolving after drug discontinuation.

Area of Science:

  • Rheumatology
  • Clinical Medicine
  • Pharmacology

Background:

  • Methotrexate (MTX) is a common disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis.
  • Serositis, including pericarditis, is a rare but recognized complication of MTX therapy.

Observation:

  • A 60-year-old male patient with rheumatoid arthritis developed acute pericarditis shortly after weekly MTX administration.
  • The pericarditis recurred within hours following two subsequent weekly MTX doses.
  • Pericarditis symptoms completely resolved after MTX was discontinued and did not recur over a three-year follow-up period.

Findings:

  • The temporal association between MTX dosing and pericarditis onset, recurrence, and resolution strongly suggests MTX-induced pericarditis.
  • This case aligns with previous literature reporting MTX-associated serositis.

Implications:

  • Clinicians should consider MTX-induced pericarditis in rheumatoid arthritis patients presenting with pleuritic chest pain or pericarditis symptoms.
  • Discontinuation of MTX should be strongly considered in cases of suspected MTX-induced pericarditis.
  • This case underscores the importance of vigilant monitoring for rare adverse drug reactions during long-term MTX therapy.

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