title: A Fatal Case of Acute Myeloid Leukaemia-Methotrexate Related or Primary Autoimmune Disease Related: A Rare Case Report.
abstract: Methotrexate is being used for many years in the treatment of chronic medical disorders e.g. rheumatoid arthritis since 1951. It has been associated with various systemic toxicities and complications including bone marrow suppression and lymphomas. The development of leukaemia in a patient of chronic rheumatoid arthritis is either related with the primary disease or due to the drugs which are used in the treatment like cyclophosphamide. In our present case, a 70-year-old female who was a known case of Rheumatoid Arthritis (RA) and was on methotrexate once a week orally for the past 20 years presented with complaints of loss of appetite, loss of weight and anaemia since 2 months. After thorough examination and investigation, she was diagnosed with acute myeloid leukaemia (AML-M4) with bilateral chest consolidation.
authors.affiliation: Assistant Professor, Department of Medicine, Himalayan Institute of Medical Sciences , SRHU, Jolly Grant, Dehradun, Uttarakhand, India .
authors.forename: Saurabh
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Assistant Professor, Department of Medicine, Himalayan Institute of Medical Sciences , SRHU, Jolly Grant, Dehradun, Uttarakhand, India .
authors.forename: Nidhi
authors.initials: N
authors.lastname: Kaeley
authors.affiliation: Senior Resident, Department of Microbiology, Himalayan Institute of Medical Sciences , SRHU, Jolly Grant, Dehradun, Uttarakhand, India .
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Assistant Professor, Department of Pathology, Himalayan Institute of Medical Sciences , SRHU, Jolly Grant, Dehradun, Uttarakhand, India .
authors.forename: Vibha
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Assistant Professor, Department of Anaesthesia, Himalayan Institute of Medical Sciences , SRHU, Jolly Grant, Dehradun, Uttarakhand, India .
authors.forename: Rohan
authors.initials: R
authors.lastname: Bhatia
keywords: Bone marrow suppression; Chest consolidation; Rheumatoid arthritis; Systemic toxicities