title: Adverse effects of methotrexate in three psoriatic arthritis patients.
abstract: Methotrexate, a folic acid analogue with anti-proliferative and anti-inflammatory effects, is commonly used to treat patients with severe destructive psoriatic arthritis and has considerable efficacy. Combined anti-tumor necrosis factor and MTX therapy result in less treatment discontinuation due to adverse events. Despite its efficacy, MTX may result in adverse effects including hepatic, pulmonary, and renal toxicity as well as lymphoproliferative disorders and predisposition to infection. We herein report rare adverse effects of MTX treatment, specifically asymptomatic pulmonary tuberculosis, renal cell carcinoma, and lateral uveitis, in three psoriatic arthritis patients treated with MTX. MTX is an important drug for the treatment for psoriatic arthritis patient, but an awareness of the possible adverse effects is needed.
authors.affiliation: Department of Dermatology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0374, Japan, hm4765@yahoo.co.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Maejima
authors.forename: Akira
authors.initials: A
authors.lastname: Watarai
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nakano
authors.forename: Chieko
authors.initials: C
authors.lastname: Katayama
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Kensei
authors.initials: K
authors.lastname: Katsuoka
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D058070:Asymptomatic Diseases; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D009392:Nephrectomy; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D014605:Uveitis / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents; D008727:Methotrexate