Abstract
A 72 year-old man with steroid-dependent ulcerative colitis was treated with methotrexate at 25 mg subcutaneous weekly. Three days after the second injection of methotrexate a pancytopenia occurred associated with a Klebsiella pneumoniae septicemia which evolution was favourable under treatment. Pancytopenia is a rare but severe adverse effect of low-dose methotrexate therapy. In our patient the risk factors were age upper than 65 years, renal insufficiency and hypoalbuminemia. This report emphasizes the need for a close monitoring of hematologic tests after onset of methotrexate particularly if some risk factors are present.
MeSH terms
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Aged
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Colitis, Ulcerative / drug therapy*
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Folic Acid Antagonists / administration & dosage
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Folic Acid Antagonists / adverse effects*
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Humans
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Hypoalbuminemia / complications
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / adverse effects*
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Injections, Subcutaneous
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Klebsiella Infections / microbiology
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Klebsiella pneumoniae
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Male
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Methotrexate / administration & dosage
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Methotrexate / adverse effects*
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Pancytopenia / chemically induced*
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Proctocolitis / drug therapy*
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Renal Insufficiency / complications
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Risk Factors
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Sepsis / microbiology
Substances
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Folic Acid Antagonists
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Immunosuppressive Agents
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Methotrexate