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KMID : 0882420090770050637
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Korean Journal of Medicine
2009 Volume.77 No. 5 p.637 ~ p.642
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Low-dose methotrexate-induced pancytopenia in three patients with impaired renal function
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Ko Sun-Hee
Yang Chul-Woo
Lee Han-Hee
Jeong Seung-Min
Kim Jin-Seok
Shin Ah-Young
Chang Mine-Ok
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Abstract
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Methotrexate (MTX) is indicated for patients with moderate to severe rheumatoid arthritis (RA), but it sometimes causes severe hematologic complications in patients with impaired renal function. We experienced three cases of pancytopenia due to low-dose MTX treatment in RA patients with impaired renal function. Two patients were dialysis patients, and the other had stage 4 chronic kidney disease. The mean cumulative MTX dose and treatment duration for the three patients was 25 mg and 10 days, respectively. All cases experienced severe stomatitis and pancytopenia and recovered with conservative care. In conclusion, MTX should be used cautiously in patients with impaired renal function.
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KEYWORD
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Methotrexate, Impaired renal function, Pancytopenia
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