Combined acute interstitial pneumonitis and pancytopenia induced by low-dose methotrexate in a hemodialysis patient treated for bullous pemphigoid*
Methotrexate has been widely used for many years in the treatment of a variety of diseases. Acute pneumonitis and bone marrow suppression are very serious side effects in methotrexate treatment. A 48-year-old man with end-stage renal disease undergoing chronic hemodialysis developed combined acute p...
| Main Authors: | , , , , |
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| Format: | Online |
| Language: | English |
| Published: |
Sociedade Brasileira de Dermatologia
2015
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540505/ |
| Summary: | Methotrexate has been widely used for many years in the treatment of a variety of
diseases. Acute pneumonitis and bone marrow suppression are very serious side effects
in methotrexate treatment. A 48-year-old man with end-stage renal disease undergoing
chronic hemodialysis developed combined acute pneumonitis and pancytopenia after a
cumulative dose of 20 mg methotrexate for bullous pemphigoid. Continuous renal
replacement therapy (CRRT) can effi ciently decrease serum methotrexate
concentration. A rapid improvement of clinical symptoms and resolution of pulmonary
opacifi cation were found after CRRT. Blood cell counts returned to normal after
component blood transfusion and cytokine supportive therapy. Patients with impaired
renal function are at high risk of methotrexate toxicity, and low-dose methotrexate
should be prescribed with great caution. |
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