Pancytopenia and colitis with Clostridium difficile in a rheumatoid arthritis patient taking methotrexate, antibiotics and non-steroidal anti-inflammatory drugs.
Methotrexate (MTX) is widely used despite its side-effects. We describe a rheumatoid arthritis (RA) patient taking low-dose MTX who developed severe pancytopenia and colitis with Clostridium difficile after the administration of antibiotics for acute pyelonephritis. Our case suggests that low-dose MTX may seriously interact with antibiotics and that these side-effects should always be considered when RA patients are treated with MTX and antibiotics.
Institute of Rheumatology, Tokyo Women's Medical University, Japan. ynn@ior.twmu.ac.jp
Y
Y
Nanke
S
S
Kotake
H
H
Akama
M
M
Tomii
N
N
Kamatani
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D016360:Clostridioides difficile; D004347:Drug Interactions; D004761:Enterocolitis, Pseudomembranous / Q000150:complications / Q000382:microbiology*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D010198:Pancytopenia / Q000150:complications*
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008727:Methotrexate