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Combined acute interstitial pneumonitis and pancytopenia induced by low-dose methotrexate in a hemodialysis patient treated for bullous pemphigoid
Liu, Haibo; Liu, Fang; Zhang, Min; Yan, Wenliang; Sang, Hong.
  • Liu, Haibo; Nanjing University. Nanjing. CN
  • Liu, Fang; Nanjing University. Nanjing. CN
  • Zhang, Min; Nanjing University. Nanjing. CN
  • Yan, Wenliang; Nanjing University. Nanjing. CN
  • Sang, Hong; Nanjing University. Nanjing. CN
An. bras. dermatol ; 90(3,supl.1): 43-45, May-June 2015. ilus
Article in English | LILACS | ID: lil-755762
ABSTRACT
Abstract

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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Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pancytopenia / Methotrexate / Pemphigoid, Bullous / Lung Diseases, Interstitial / Dermatologic Agents Type of study: Etiology study Limits: Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2015 Type: Article Affiliation country: China Institution/Affiliation country: Nanjing University/CN

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Full text: Available Index: LILACS (Americas) Main subject: Pancytopenia / Methotrexate / Pemphigoid, Bullous / Lung Diseases, Interstitial / Dermatologic Agents Type of study: Etiology study Limits: Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2015 Type: Article Affiliation country: China Institution/Affiliation country: Nanjing University/CN