Hemophagocytic Syndrome Caused by Methotrexate Overdose in a Total Knee Arthroplasty Patient: A Case Report

Area of Science:

• Rheumatology
• Hematology
• Toxicology

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory disorder.
• Methotrexate (MTX) is a common treatment for RA.
• Hemophagocytic syndrome (HPS) is a severe, life-threatening condition.

Purpose of the Study:

• To report a rare case of HPS secondary to MTX overdose in an RA patient.
• To highlight the importance of thorough drug history in patients with inflammatory disorders.

Main Methods:

• Case report of a patient with RA.
• Investigation of HPS attributed to MTX overdose and sepsis.
• Utilized patient history, physical examination, and laboratory tests for diagnosis.

Main Results:

• The patient, diagnosed with RA, developed HPS.
• HPS was linked to sepsis, resulting from MTX overdose.
• Epidermolysis bullosa and gastrointestinal ulcers aided in identifying the MTX overdose.

Conclusions:

• Thorough drug history is essential for patients with inflammatory conditions like RA, especially those undergoing procedures like arthroplasty.
• Accurate diagnosis relies on comprehensive patient history, physical examination, and appropriate laboratory investigations.