CASE REPOCASE REPORT ON METHOTREXATE-INDUCED ANGIOEDEMA, PANCYTOPENIA, AND STEVENS-JOHNSON SYNDROMERT ON METHOTREXATE INDUCED ANGIOEDEMA, PANCYTOPENIA AND STEVENS - JOHNSON SYNDROME
Abstract
ABSTRACT
A 52-year-old female patient was presented with the complaints of swelling of lips, difficulty in breathing, difficulty in swallowing of food, itching,
and facial puffiness and also showed the history of a skin lesion in the neck, forearm, and genitalia. Medical history of the patient showed that she
had been prescribed with methotrexate for rheumatoid arthritis. Within 10 days of treatment, the patient developed above mentioned signs and
symptoms. Further upon patient's systemic and physical examinations were done and then a diagnosis of pancytopenia, angioedema, and StevensJohnson
syndrome
were
made. According
to
Naranjo
adverse
drug
reaction
causality assessment
scale,
the association of
angioedema,
pancytopenia,
and
Stevens-Johnson
syndrome
due to
methotrexate
was
probable.
Methotrexate
was
withdrawn
from
the patient,
and the patient was
treated
with
methotrexate
antagonist Leucovorin
for
3
days
with a
frequency
of thrice daily
and injection Avil
(Pheniramine
maleate)
with a
frequency
of twice
daily
which
resolved
the complications of the patient.
Keywords: Methotrexate, Angioedema, Pancytopenia, Stevens-Johnson syndrome.
Downloads
References
REFERENCES
Barar FS. Cytotoxic drugs. Essential of Pharmacotherapeutics. 5
ed.
New Delhi: S. Chand and Company Ltd.; 2008. p. 477, 481-82.
th
Preet Singh Y, Aggarwal A, Misra R, Agarwal V. Low-dose
methotrexate-induced pancytopenia. Clin Rheumatol 2007;26:84-7.
Walker R, Whittlesea C. Drug induced skin disorder. Clinical Pharmacy
and Therapeutics. 4
ed. China: Elsevier; 2008. p. 811-12.
Robbins, Catron, Vinay Kumar.Abul K. Abbas,Nelson Fausto,Jon
th
C.Aster. The skin. Robbins and Cotran Pathologic Basis of Disease.
ed. Philadelphia, Pennsylvania: Elsevier; 2010. p. 1189.
Mohan H. Systemic pathology. The skin. Textbook of Pathology. 6
th
ed.
New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2010. p. 522,
Gonzalez-Ibarra F, Eivaz-Mohammadi S, Surapaneni S, Alsaadi H,
Syed AK, Badin S, et al. Methotrexate induced pancytopenia. Case Rep
Rheumatol 2014;2014:679580.
Morgan SL, Baggott JE, Vaughn WH, Austin JS, Veitch TA, Lee JY,
et al. Supplementation with folic acid during methotrexate therapy
for rheumatoid arthritis. A double-blind, placebo-controlled trial. Ann
Intern Med 1994;121:833-41.
Van Ede AE, Laan RF, Rood MJ, Huizinga TW, van de Laar MA,
van Denderen CJ, et al. Effect of folic or folinic acid supplementation
on the toxicity and efficacy of MTX in rheumatoid arthritis: A forty
eight week, multicenter, randomized, double-blinded, placebocontrolled
study.
Arthritis
Rheum 2001;44(7):1515-24.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.