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Methotrexate-Induced Pancytopenia and Mucositis Caused by Medication Error

Maame-Boatemaa Amissah-Arthur1, Winifred Baah2

  • 1University of Ghana Medical School, Department of Medicine and Therapeutics, Accra, Ghana.

Ghana Medical Journal
|September 1, 2020
PubMed

Insights

Methotrexate toxicity can cause severe side effects like pancytopenia and mucositis, even with a good safety profile. Careful dosing and monitoring are crucial for patients, especially those with risk factors like kidney impairment.

Area of Science:

  • Pharmacology
  • Rheumatology
  • Oncology

Background:

  • Methotrexate is increasingly used across rheumatology, dermatology, oncology, and obstetrics.
  • General clinicians frequently manage patients prescribed methotrexate.

Observation:

  • A 45-year-old woman with rheumatoid arthritis developed acute pancytopenia and mucositis.
  • This presentation was attributed to methotrexate toxicity.

Findings:

  • Methotrexate toxicity risk is influenced by factors including age, renal function, folate status, albumin levels, and drug interactions.
  • The case highlights the potential for severe adverse events despite methotrexate's generally favorable safety profile.

Implications:

  • Accurate dosing regimens are essential to minimize prescribing errors and prevent methotrexate toxicity.
  • Awareness of risk factors and potential complications is vital for clinicians managing methotrexate therapy.
Keywords:
Methotrexatemedication errormucositispancytopeniaside-effects

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