title: Methotrexate induced pneumatosis intestinalis under hemodialysis patient.
abstract: Pneumatosis intestinalis (PI) is a rare disorder characterized by the gas within the intestinal mucosa. This is the first report methotrexate (MTX) induced PI under hemodialysis (HD) patient. A 46-year-old man suffered rheumatoid arthritis and underwent HD at local HD center. After the initial induction of MTX, the patient showed epigastralgia and diarrhea. He was referred to our hospital and abdominal computed tomography showed significant large intestinal edema and free intraperitoneal air consistent with PI. Physicians should aware that MTX is contraindication drug for chronic kidney disease and high-flux HD may decrease MTX toxicity and oxidative stress, improving PI.
authors.affiliation: Department of Nephrology, Kindai University Nara Hospital, Kindai University Faculty of Medicine, Nara, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mima
authors.affiliation: Department of Nephrology, Kindai University Nara Hospital, Kindai University Faculty of Medicine, Nara, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Nagahara
authors.affiliation: Department of Nephrology, Kindai University Nara Hospital, Kindai University Faculty of Medicine, Nara, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Tansho
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced*; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate
keywords: Pneumatosis intestinalis (PI); chronic kidney disease (CKD); hemodialysis (HD); methotrexate (MTX)