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Low-Dose Methotrexate Toxicity Presenting as Pancytopenia.
Gundip S Dhillon1, Sukhjinder Chauhan2, Yema Jalal1
1Internal Medicine, MountainView Hospital, Las Vegas, USA.
Cureus
|January 19, 2023
Summary
Low-dose methotrexate, used for autoimmune diseases, can rarely cause severe pancytopenia. This case highlights a rare but serious side effect in an elderly patient, successfully treated with leucovorin and G-CSF.
Area of Science:
- Pharmacology
- Hematology
- Toxicology
Background:
- High-dose methotrexate (MTX) is used for malignancies, carrying risks like kidney injury and myelosuppression.
- Low-dose MTX is a standard, generally safe treatment for autoimmune arthropathies.
- Rarely, low-dose MTX can cause severe toxicity, including pancytopenia.
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