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Abstract

Methotrexate (MTX) has an antiproliferative, anti-inflammatory, immunomodulatory, and immunosuppressive activity which is used in the treatment of many diseases such as Rheumatoid arthritis (RA), psoriasis, vasculitis, systemic lupus erythematosus, connective tissue diseases. This report describes the 2 cases of MTX-induced pancytopenia. Case 1; A 60-year-old female was having C/o loose motion 5-7 episodes for 2 days, severe generalized weakness, dark colour stool, itchy rashes over the body, cheeks, inside the mouth, and buccal mucosa with RA, and was taking Tablet (Tab) Methotrexate 5 Mg on Saturday and Sunday, Tab Folic Acid 5mg once a day Monday to Friday for 3 months. The patient did not have a proper outpatient monitor of blood investigation resulting in toxicity. She was hospitalized, MTX withdrawn, and treated with folinic acid. Case 2; A 76 years male was admitted to Bombay port trust hospital with a chief complaint of bleeding from the groin region associated with burning, itching, pain, foul smell with skin maceration over the scrotum and penis, low back pain, severe generalized weakness, increased frequency of urination. The patient was case psoriasis on methotrexate for 1 year without a monitor of CBC, kidney, or liver function tests and had taken it continuously resulting in toxicity. He was hospitalized, MTX withdrawn, and treated symptomatically. Our case highlights the importance of counselling to ensure adherence to the correct MTX treatment regimen to prevent toxicity and its serious effects and a new alternative therapeutic method to treat autoimmune disease without measuring side effects and toxicity.

Keywords

Methotrexate, Overdose, Psoriasis, Pancytopenia, Rheumatoid arthritis

Reference

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Abdullah Ismail Bhoraniya
Corresponding author

Mumbai port trust hospital, Wadala east, Mumbai, Maharashtra- 400037.

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Asad Sayyed
Co-author

Mumbai port trust hospital, Wadala east, Mumbai, Maharashtra- 400037.

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Surekha Hoskeri
Co-author

Mumbai port trust hospital, Wadala east, Mumbai, Maharashtra- 400037.

Abdullah Ismail Bhoraniya*, Asad Sayyed, Surekha Hoskeri, Methotrexate Induced Pancytopenia In A Patient With Rheumatoid Arthritis And Psoriasis: A Case Report, Int. J. in Pharm. Sci., 2023, Vol 1, Issue 5, 268-273. https://doi.org/10.5281/zenodo.7958450

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