title: Leukemoid reaction after methotrexate-induced pancytopenia in a patient undergoing continuous ambulatory peritoneal dialysis.
abstract: Methotrexate has been used as an important alternative therapy in the treatment of various rheumatic diseases. Life threatening marrow suppression in end-stage renal disease patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis has been reported. A 33-year-old woman with systemic lupus erythematosus undergoing chronic peritoneal dialysis developed severe mucositis and pancytopenia after low-dose methotrexate treatment for arthritis. The leukocyte count recovered after methotrexate was withdrawn but a leukemoid blood picture developed during her recovery. No evidence of leukemia was found on bone marrow biopsy. The leukocyte count gradually returned to normal with conservative therapy.
authors.affiliation: Division of Nephrology, Chang Gung Memorial Hospital. 222, Maijin Rd., Anle Chiu, Keelung, Taiwan 204, ROC.
authors.forename: Chiao-Ying
authors.initials: CY
authors.lastname: Sun
authors.forename: Hou-Chang
authors.initials: HC
authors.lastname: Lin
authors.forename: Yung-Chih
authors.initials: YC
authors.lastname: Chen
authors.forename: Chi-Ren
authors.initials: CR
authors.lastname: Tsai
authors.forename: Mai-Szu
authors.initials: MS
authors.lastname: Wu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007955:Leukemoid Reaction / Q000139:chemically induced*; D008180:Lupus Erythematosus, Systemic / Q000628:therapy; D008727:Methotrexate / Q000009:adverse effects*; D010198:Pancytopenia / Q000139:chemically induced*; D010531:Peritoneal Dialysis, Continuous Ambulatory
chemical_list: D008727:Methotrexate