title: [Pancytopenia induced by two low-dose injections of methotrexate in a patient treated for ulcerative colitis].
abstract: 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.
authors.affiliation: Service d'hépatogastroentérologie, Centre hospitalier Lyon-Sud, Pierre-Bénite.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Chalumeau
authors.forename: Driffa
authors.initials: D
authors.lastname: Moussata
authors.forename: Stéphane
authors.initials: S
authors.lastname: Nancey
authors.forename: Sylvette
authors.initials: S
authors.lastname: Claudel-Bonvoisin
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Saurin
authors.forename: Bernard
authors.initials: B
authors.lastname: Flourié
mesh_terms: 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
chemical_list: D005493:Folic Acid Antagonists; D007166:Immunosuppressive Agents; D008727:Methotrexate