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Porphyria cutanea tarda associated with methotrexate therapy
T O'Neill1, J Simpson, S J Smyth
1Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath.
British Journal of Rheumatology
|May 1, 1993
Summary
Methotrexate therapy can trigger porphyria cutanea tarda in rheumatoid arthritis (RA) patients. This case report details the clinical and laboratory findings of this rare adverse drug reaction.
Area of Science:
- Rheumatology
- Dermatology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Methotrexate is a common disease-modifying antirheumatic drug (DMARD).
- Porphyria cutanea tarda (PCT) is a photosensitive disorder.
Observation:
- A 69-year-old female patient with RA was treated with methotrexate.
- Two weeks after initiating methotrexate, the patient developed symptoms of PCT.
- Clinical presentation included skin fragility and blistering.
Findings:
- Laboratory tests confirmed elevated porphyrin levels, indicative of PCT.
- The patient's condition was directly linked to methotrexate initiation.
- This suggests a potential drug-induced mechanism for PCT.
Implications:
- Clinicians should be aware of the potential for methotrexate to induce PCT.
- Early recognition and discontinuation of methotrexate may be crucial for management.
- Further research into the mechanisms of drug-induced PCT is warranted.