Abstract

GONZALEZ-MARTINEZ, Daniel Felipe; CABRERA-VELASCO, Carlos Ernesto; CHILITIO ZEMANATE, Paulo Andrés  and  VERHELST-SOLANO, José Luis. Low dose methotrexate induced pancytopenia. CES Med. [online]. 2019, vol.33, n.2, pp.119-125. ISSN 0120-8705.  https://doi.org/10.21615/cesmedicina.33.2.5.

Methotrexate is an agent that antagonizes the metabolism of folic acid by reducing the levels of tetrahydrofolate in cells, which inhibits cellular replication and protein synthesis. It is currently used in the treatment of various malignancies and some inflammatory diseases such as rheumatoid arthritis. It has described numerous toxic effects both at high doses in chemotherapeutic schemes and long-term low doses for immunosuppression; these include renal, hepatic, neurological, cutaneous, gastrointestinal, and much less frequently pulmonary and hematological involvement. This article reports the case of an elderly patient who was in treatment with methotrexate for more than four years and went to the emergency department with severe toxicity highlighting pancytopenia and concomitant septic shock, whom despite the established management presented a poor response. The importance of taking into account this toxicity is highlighted given the underreporting in Colombia and the impact it can have on a patient even when establishing the appropriate management.

Keywords : Methotrexate; Toxcity; Pancytopenia.

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