Combined acute interstitial pneumonitis and pancytopenia induced by low-dose methotrexate in a hemodialysis patient treated for bullous pemphigoid

Anais Brasileiros de Dermatologia

Haibo Liu¹  Fang Liu¹  Min Zhang¹  Wenliang Yan¹  Hong Sang¹ 

关键词: Methotrexate;    Pancytopenia;    Pneumonia;    Renal dialysis;   

DOI  :  10.1590/abd1806-4841.20153692

来源: SciELO

【 摘 要 】

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.

【 授权许可】

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