title: Methotrexate induced sprue-like syndrome.
abstract: A 52 year-old male patient diagnosed of ankylosing spondylitis presented with an iron deficiency anemia after a ten-month treatment of methotrexate. He did not respond to treatment with oral iron not a proton pump inhibitor and an upper endoscopy was performed. The histological study of the duodenal biopsies showed villus atrophy. After removing the methotrexate, administering intramuscular iron and undertaking a gluten-free diet, the histological and analytical alterations progressively resolved.
authors.affiliation: Gastroenterology Department, Hospital Clinic Universitari of Valencia, Universitat de Valencia Avda. Blasco Ibanez 17 46010 Valencia, Spain. maiabosca@yahoo.es.
authors.forename: Marta Maia
authors.initials: MM
authors.lastname: Boscá
authors.forename: Ramon
authors.initials: R
authors.lastname: Añón
authors.forename: Empar
authors.initials: E
authors.lastname: Mayordomo
authors.forename: Rosana
authors.initials: R
authors.lastname: Villagrasa
authors.forename: Nelly
authors.initials: N
authors.lastname: Balza
authors.forename: Cirilo
authors.initials: C
authors.lastname: Amorós
authors.forename: Juan Ramon
authors.initials: JR
authors.lastname: Corts
authors.forename: Adolfo
authors.initials: A
authors.lastname: Benages
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001284:Atrophy; D001706:Biopsy; D002446:Celiac Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D013577:Syndrome
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate