[Pancytopenia induced by two low-dose injections of methotrexate in a patient treated for ulcerative colitis].
A 72 year-old man with steroid-dependent ulcerative colitis was treated with methotrexate at 25 mg subcutaneous weekly. Three days after the second injection of methotrexate a pancytopenia occurred associated with a Klebsiella pneumoniae septicemia which evolution was favourable under treatment. Pancytopenia is a rare but severe adverse effect of low-dose methotrexate therapy. In our patient the risk factors were age upper than 65 years, renal insufficiency and hypoalbuminemia. This report emphasizes the need for a close monitoring of hematologic tests after onset of methotrexate particularly if some risk factors are present.
Chalumeau
Sylvaine
S
Service d'hépatogastroentérologie, Centre hospitalier Lyon-Sud, Pierre-Bénite.
Moussata
Driffa
D
Nancey
Stéphane
S
Claudel-Bonvoisin
Sylvette
S
Saurin
Jean-Christophe
JC
Flourié
Bernard
B
D000368:Aged; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005493:Folic Acid Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D010198:Pancytopenia / Q000139:chemically induced*; D011350:Proctocolitis / Q000188:drug therapy*; D051437:Renal Insufficiency / Q000150:complications; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology
D005493:Folic Acid Antagonists; D007166:Immunosuppressive Agents; D008727:Methotrexate