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Bir Hemodiyaliz Hastasında Düşük Doz Metotreksat Sonucu Gelişen Şiddetli Pansitopeni

Severe Pancytopenia Induced by Low-dose Methotrexate in a Hemodialysis Patient

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DOI: 
doi: 10.5262/tndt.2010.1002.75

Keywords (Original Language):

Abstract (2. Language): 
Methotrexate has been used as an important alternative therapy in the treatment of various rheumatic diseases. It is primarily cleared by the kidney. Life-threatening marrow suppression in hemodialysis patients has been reported. A 35-year-old woman undergoing hemodialysis developed severe stomatitis and pancytopenia after low-dose methotrexate treatment for rheumatoid arthritis. She recovered after folinic acid, granulocyte colony-stimulating factor, antibiotic and daily hemodialysis therapy.
Abstract (Original Language): 
Metotreksat, çeşitli romatizmal hastalıkların tedavisinde kullanılan önemli bir seçenek olup temel atılım yolu böbreklerdir. Hemodiyaliz tedavisi alan hastalarda metotreksat kullanımı sırasında ciddi pansitopeni görülebilmektedir. Bu makalede, hemodiyaliz programında olan ve romatoid artrit tedavisi için düşük doz metotreksat kullanımı sonucu şiddetli pansitopeni ve stomatit gelişen; folinik asit, granülosit koloni uyarıcı faktör, antibiyotik ve günlük diyaliz sonrası düzelen 35 yaşındaki kadın olguyu sunduk.
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REFERENCES

References: 

1. Cronstein BN: Molecular therapeutics. Methotrexate and its
mechanisms of action. Arthritis Rheum 1996; 39:1951-1960
2. Basile C, Montanaro A, Semeraro A. Should low-dose methotrexate
therapy be prescribed to dialysis patients? Nephrol Dial Transplant
2002; 17:530-531
3. Cheung KK, Chow KM, Szeto CC, Tai MH, Kwan BC, Li PK.Fatal
pancytopenia in a hemodialysis patient after treatment with lowdose
methotrexate. J Clin Rheumatol 2009; 15:177-180
4. Sun CY, Lin HC, Chen YC, Tsai CR, Wu MS: Leukemoid reaction
after methotrexate-induced pancytopenia in a patient undergoing
continuous ambulatory peritoneal dialysis. Chang Gung Med 2006;
29:513-516
5. Diskin CJ, Stokes TJ, Dansby LM, Radcliff L, Carter TB: Removal
of methotrexate by peritoneal dialysis and hemodialysis in a single
patient with end-stage renal disease. Am J Med Sci 2006; 332:
156-158
6. Kremer JM, Lee JK: The safety and effi cacy of the use of
methotrexate in long-term therapy for rheumatoid arthritis. Arthritis
Rheum 1986; 29:822-831
7. Gutierrez-Ureña S, Molina JF, García CO, Cuéllar ML, Espinoza
LR: Pancytopenia secondary to methotrexate therapy in rheumatoid
arthritis. Arthritis Rheum 1996; 39:272-276
8. Rheumatoid arthritis Clinical Trial Archive Group: The effect of age
and renal function on the effi cacy and toxicity of methotrexate in
rheumatoid arthritis. J Rheumatol 1995; 22:218-223
9. Ellman MH, Ginsberg D: Low dose methotrexate and severe
neutropenia in patients undergoing renal dialysis. Arthritis Rheum
1990; 33 (7):1060-1061
10. Cohen PR, Schulze KE, Nelson BR: Pancytopenia after a single
intradermal infi ltration of methotrexate. J Drugs Dermatol 2005;
4:648-651
11. Seyffart G. Poison Index: The treatment of acute intoxication.
Lengerich: Pabst Science Publishers, 1997; 449-451
12. Wall SM, Johansen MJ, Molony DA, DuBose TD Jr, Jaffe N,
Madden T: Effective clearance of methotrexate using high-fl ux
hemodialysis membranes. Am J Kidney Dis 1996; 28:846-854
13. Seneschal J, Héliot-Hostein I, Taieb A: Pancytopenia induced by
low-dose methotrexate in a haemodialysis patient treated for bullous
pemphigoid. J Eur Acad Dermatol 2007; 21:1135-1136

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