Low-Dose Methotrexate Toxicity Presenting as Pancytopenia

Division

Far West

Hospital

Southern Hills Hospital & Medical Center

Document Type

Case Report

Publication Date

12-13-2022

Keywords

pancytopenia secondary to low-dose methotrexate, low-dose methotrexate, granulocyte colony-stimulating factor, g-csf, poison control, sodium bicarbonate, leucovorin, methotrexate toxicity

Disciplines

Hemic and Lymphatic Diseases | Internal Medicine

Abstract

High-dose methotrexate (MTX, 5 g/week) is typically used for the treatment of different malignancies and may be associated with serious side effects, such as acute kidney injury, myelosuppression, and hepatotoxicity. On the other hand, low-dose MTX (10-25 mg/week) is considered to be a safe and effective treatment for autoimmune arthropathies. Toxicity due to low-dose MTX is rare but can present with serious complications, such as pancytopenia.

In this report, we present the case of an 82-year-old woman who presented with low-dose, MTX-induced severe pancytopenia and was treated with leucovorin rescue therapy with granulocyte colony-stimulating factor (G-CSF) therapy.

Publisher or Conference

Cureus

Link to Full Text

Share

COinS