title: Pott's disease and hypercalcemia in a patient with rheumatoid arthritis receiving methotrexate monotherapy.
abstract: Methotrexate (MTX) may have adverse effects on multiple organs and system. A few cases of pulmonary tuberculosis in-patients with rheumatoid arthritis (RA) while receiving MTX monotherapy has been reported in the literature. We submit a case of vertebral tuberculosis with hypercalcemia in a patient receiving MTX monotherapy. Patient with RA taking MTX for 15 years developed pancytopenia, skin necrosis, tuberculous spondylodiscitis and hypercalcemia. The present case showed adverse effects of MTX therapy may occur even after years of continuous treatment. Due to pancytopenia in older patients, life-threatening tuberculosis at unusual sites may develop.
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Zorlu
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Kiskac
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Cumali
authors.initials: C
authors.lastname: Karatoprak
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cakirca
authors.affiliation: Family Medicine Clinic, Recep Tayyip Erdogan University, Faculty of Medicine, 53100 Rize, Turkey.
authors.forename: Erdinç
authors.initials: E
authors.lastname: Yavuz
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Güven
authors.initials: G
authors.lastname: Cetin
authors.affiliation: Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Cıkrıkçıoğlu
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use*; D014399:Tuberculosis, Spinal / Q000150:complications*
chemical_list: D007166:Immunosuppressive Agents; D008727:Methotrexate
keywords: Hypercalcemia; Pott's disease; methotrexate; pancytopenia; rheumatoid arthritis