Non-coeliac sprue possibly related to methotrexate in a rheumatoid arthritis patient.
We describe a case of non-coeliac sprue in a low-dose methotrexate treated patient suffering from rheumatoid arthritis. This is the first case report of this possibly reversible complication of methotrexate therapy. The diagnosis was confirmed by a duodenal mucosal biopsy revealing the characteristic intestinal histopathology of coeliac sprue. After discontinuation of the drug a repeat biopsy was almost normal, and completely normal after reintroduction of a normal diet. One could speculate about the methotrexate related mechanism of the villous atrophy: it might be either a direct toxic effect or a secondary effect of the immunosuppression.
Houtman
P M
PM
Department of Rheumatology, Medical Centre Leeuwarden, Netherlands.
Hofstra
S S
SS
Spoelstra
P
P
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001706:Biopsy; D002446:Celiac Disease / Q000139:chemically induced* / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*
D008727:Methotrexate