Methotrexate induced sprue-like syndrome.
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.
Boscá
Marta Maia
MM
Gastroenterology Department, Hospital Clinic Universitari of Valencia, Universitat de Valencia Avda. Blasco Ibanez 17 46010 Valencia, Spain. maiabosca@yahoo.es.
Añón
Ramon
R
Mayordomo
Empar
E
Villagrasa
Rosana
R
Balza
Nelly
N
Amorós
Cirilo
C
Corts
Juan Ramon
JR
Benages
Adolfo
A
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
D018501:Antirheumatic Agents; D008727:Methotrexate