One Case Report of MTX-Induced Aplastic Anemia and Literature Review_Chinese Journal of Evidence-Based Medicine

Authors：

Zhang Rui , YU Lei , JIA Ping , LI Mei ,  Fei Xiaofan

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Fei Xiaofan, Email: fxiaofan@yahoo.com.cn

Keywords：

Methotrexate (MTX); Aplastic anemia; Literature review

DOI：

10.7507/1672-2531.20090198

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

We reported one case of MTX-induced aplastic anemia and reviewed related literature to investigate the mechanism of action of MTX, and summarize the clinical feature, diagnostic criteria, risk factor, and interventions. These were hoped to arouse the attention of clinicians and clinical pharmacists, in order to effectively prevent, diagnose, and treat MTX-induced aplastic anemia.

Citation： Zhang Rui,YU Lei,JIA Ping,LI Mei,Fei Xiaofan. One Case Report of MTX-Induced Aplastic Anemia and Literature Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(10): 1121-1123. doi: 10.7507/1672-2531.20090198 Copy

1.	叶任高, 陆在英. 主编. 内科学. 第6版. 北京: 人民卫生出版社, 2005: 572-576.
2.	张象麟. 药物临床信息参考2006. 第1版. 成都: 四川科学技术出版社, 2006: 902-904.
3.	周惠琼, 吴东海, 马丽. 短期小剂量甲氨蝶呤导致严重不良反应临床分析. 中华风湿病学杂志, 2002, 6(2): 135-137.
4.	Gutierrez-Urena S, Molina JF, Garcia CO, et al. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum, 1996, 39(2): 272-276.
5.	Lim AY, Gaffney K, Scott DG. Methotrexate-induced pancytopenia: serious and under-reported? Our experience of 25 cases in 5 years. Rheumatology (Oxford), 2005, 44(8): 1051-1055.
6.	张昆鹏. 甲氨蝶呤在日本导致134例患者死亡. 世界临床药物, 2005, 26(4): 196.
7.	杨毅, 张英, 王善昌. MTX致全血减少症的临床分析. 现代口腔医学杂志, 1999, 13(1): 44-45.
8.	Basile C, Montanaro A, Semeraro A. Should low-dose methotrexate therapy be prescribed to dialysis patients? Nephrol Dial Transplant, 2002, 17(3): 530-531.
9.	Nakamura M, Sakemi T, Nagasawa K. Severe pancytopenia caused by a single administration of low-dose methotrexate in a patient undergoing hemodialysis. J Rheumatol, 1999, 26(6): 1424-1425.
10.	Boulanger H, Launay-Vacher V, Hierniaux P, et al. Severe methotrexate intoxication in a haemodialysis patient treated for rheumatoid arthritis. Nephrol Dial Transplant, 2001, 16(5): 1087.
11.	Bellaiche G, Maisonneuve L, Nouts A, et al. Fatal bone marrow aplasia after the 1st injection of methotrexate in a woman with Crohn’s disease. Gastroenterol Clin Biol, 1999, 23(10):1102-1103.
12.	Rheumatoid Arthritts Clinical Trial Archive Group. The effect of age and renal function on the efficacy and toxicity of methotrexate in rheumatoid arthritis. The Journal of Rheumatol, 1995, 22(2): 2218-2231.
13.	Seyffart G. Poison Index: The Treatment of Acute Intoxication. Pabst Science Publishers, Lengerich, 1997, 449-451.
14.	Lacy C. Methotrexate: Drug Information in Drug Information Handbook. UpToDate Inc. 9. 1, Wellesley, 2001.
15.	Barrie M, Grace P, John DP. Neutropenia due to low-dose methotrexate therapy for psoriasis and rheumatoid arthritis may be fatal. Med J Aust, 1991, 155(7): 480-484.
16.	Morgan SL, Baggott J E, Vaughn WH, et al. The effect of folic acid supplementation on the toxicity of low-dose methotrexate in patients with rheumatoid arthritis. Arthritis Rheum, 1990, 33(1): 9-18.
17.	Fuest DE. Practical clinical pharmacology and drug interactions of low-dose methotrexate therapy in rheumatoid arthritis. Br J Rheumatol, 1995, 34(Suppl 2): 20-25.
18.	Seyffart G. Poison Index: The Treatment of Acute Intoxication. Pabst Science Publishers, Lengerich, 1997, 449-451.
19.	Wall SM, Johansen MJ, Molony DA, et al. Effective clearance of methatrexate using high-flux hemodialysis membranes. Am J Kidney Dis, 1996, 28(6): 846-854.
20.	Marsh JC, Ball SE, Darbyshire P, et al. Guidelines for the diagnosis and management of acquired aplastic anaemia. Br J Haematol, 2003, 123(5): 782-801.
21.	Hirohau M, Nobuaki K, Keiichiro T, et al. Autirheumatic agents I. novel methotrexate derivatives beating an indoline moiety. Chem. Pharm. Bull, 1996, 44(7): 1332.

1. 叶任高, 陆在英. 主编. 内科学. 第6版. 北京: 人民卫生出版社, 2005: 572-576.
2. 张象麟. 药物临床信息参考2006. 第1版. 成都: 四川科学技术出版社, 2006: 902-904.
3. 周惠琼, 吴东海, 马丽. 短期小剂量甲氨蝶呤导致严重不良反应临床分析. 中华风湿病学杂志, 2002, 6(2): 135-137.
4. Gutierrez-Urena S, Molina JF, Garcia CO, et al. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum, 1996, 39(2): 272-276.
5. Lim AY, Gaffney K, Scott DG. Methotrexate-induced pancytopenia: serious and under-reported? Our experience of 25 cases in 5 years. Rheumatology (Oxford), 2005, 44(8): 1051-1055.
6. 张昆鹏. 甲氨蝶呤在日本导致134例患者死亡. 世界临床药物, 2005, 26(4): 196.
7. 杨毅, 张英, 王善昌. MTX致全血减少症的临床分析. 现代口腔医学杂志, 1999, 13(1): 44-45.
8. Basile C, Montanaro A, Semeraro A. Should low-dose methotrexate therapy be prescribed to dialysis patients? Nephrol Dial Transplant, 2002, 17(3): 530-531.
9. Nakamura M, Sakemi T, Nagasawa K. Severe pancytopenia caused by a single administration of low-dose methotrexate in a patient undergoing hemodialysis. J Rheumatol, 1999, 26(6): 1424-1425.
10. Boulanger H, Launay-Vacher V, Hierniaux P, et al. Severe methotrexate intoxication in a haemodialysis patient treated for rheumatoid arthritis. Nephrol Dial Transplant, 2001, 16(5): 1087.
11. Bellaiche G, Maisonneuve L, Nouts A, et al. Fatal bone marrow aplasia after the 1st injection of methotrexate in a woman with Crohn’s disease. Gastroenterol Clin Biol, 1999, 23(10):1102-1103.
12. Rheumatoid Arthritts Clinical Trial Archive Group. The effect of age and renal function on the efficacy and toxicity of methotrexate in rheumatoid arthritis. The Journal of Rheumatol, 1995, 22(2): 2218-2231.
13. Seyffart G. Poison Index: The Treatment of Acute Intoxication. Pabst Science Publishers, Lengerich, 1997, 449-451.
14. Lacy C. Methotrexate: Drug Information in Drug Information Handbook. UpToDate Inc. 9. 1, Wellesley, 2001.
15. Barrie M, Grace P, John DP. Neutropenia due to low-dose methotrexate therapy for psoriasis and rheumatoid arthritis may be fatal. Med J Aust, 1991, 155(7): 480-484.
16. Morgan SL, Baggott J E, Vaughn WH, et al. The effect of folic acid supplementation on the toxicity of low-dose methotrexate in patients with rheumatoid arthritis. Arthritis Rheum, 1990, 33(1): 9-18.
17. Fuest DE. Practical clinical pharmacology and drug interactions of low-dose methotrexate therapy in rheumatoid arthritis. Br J Rheumatol, 1995, 34(Suppl 2): 20-25.
18. Seyffart G. Poison Index: The Treatment of Acute Intoxication. Pabst Science Publishers, Lengerich, 1997, 449-451.
19. Wall SM, Johansen MJ, Molony DA, et al. Effective clearance of methatrexate using high-flux hemodialysis membranes. Am J Kidney Dis, 1996, 28(6): 846-854.
20. Marsh JC, Ball SE, Darbyshire P, et al. Guidelines for the diagnosis and management of acquired aplastic anaemia. Br J Haematol, 2003, 123(5): 782-801.
21. Hirohau M, Nobuaki K, Keiichiro T, et al. Autirheumatic agents I. novel methotrexate derivatives beating an indoline moiety. Chem. Pharm. Bull, 1996, 44(7): 1332.

Previous Article
Clinical Analysis of Laparoscopic Operation for 36 Patients with Interstitial Tubal Pregnancy
Next Article
Evidence of Cochrane Systematic Reviews Relating to Oral Hygiene Care

Chinese Journal of Evidence-Based Medicine

One Case Report of MTX-Induced Aplastic Anemia and Literature Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content