Exacerbation of rheumatoid arthritis after termination of chemotherapy for breast carcinoma.
Three women with breast carcinoma were treated with combination chemotherapy, including cyclophosphamide, 5-fluorouracil, and methotrexate, after mastectomy. Within two months of termination of chemotherapy, all 3 patients developed florid synovitis. Two patients had prior clinical manifestations consistent with rheumatoid arthritis; one patient had no antecedent history of arthritis. We suggest that this presentation may represent exacerbation of mild or subclinical rheumatoid arthritis as a consequence of withdrawal of methotrexate therapy.
Rosenstein
E D
ED
Department of Medicine, St. Barnabas Medical Center (SBMC), Livingston, NJ, USA.
Kramer
N
N
Leitner
S P
SP
Michaelson
R A
RA
D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000209:etiology; D001943:Breast Neoplasms / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012008:Recurrence
D018501:Antirheumatic Agents; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate