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Fatal pancytopenia in a hemodialysis patient after treatment with low-dose methotrexate
Kitty Kit Ting Cheung1, Kai Ming Chow, Cheuk Chun Szeto
1Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, SAR, The People's Republic of China.
Abstract:
We report a 56-year-old male hemodialysis patient who developed fatal pancytopenia after treatment with low-dose methotrexate for psoriasis and psoriatic arthropathy. Risk factors identified included impaired renal function, concurrent use of nonsteroidal anti-inflammatory drugs, low serum albumin, and relatively low serum folate level. Literature review found similar risk factors in 12 other cases. Therefore, methotrexate, even as a single dose, should not be used to treat rheumatic conditions in dialysis patients.
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