Three cases of malignant neoplasm, pneumonitis, and pancytopenia during treatment with low-dose methotrexate
Identifieur interne : 002E51 ( Main/Exploration ); précédent : 002E50; suivant : 002E52Three cases of malignant neoplasm, pneumonitis, and pancytopenia during treatment with low-dose methotrexate
Auteurs : P. Trenkwalder [Allemagne] ; H. Eisenlohr [Allemagne] ; K. Prechtel [Allemagne] ; H. Lydtin [Allemagne]Source :
- The clinical investigator [ 0941-0198 ] ; 1992-10-01.
English descriptors
- KwdEn :
- Teeft :
- Alveolar infiltrates, Arthritis, Asthma, Asthmatic patients, Bladder, Bowel disease, Carcinogenicity, Causal relationship, Cell carcinoma, Drug interactions, Dyspnea, Lung disease, Malignant, Malignant neoplasm, Malignant neoplasms, Malignant teratoma, Mediastinal, Mediastinal mass, Methotrexate, Methotrexate pneumonitis, Methotrexate therapy, Neoplasm, Nsaid, Pancytopenia, Pneumonitis, Psoriasis, Psoriatic arthritis, Pulmonary disease, Renal, Renal function, Rheumatoid, Rheumatoid arthritis, Risk factors, Several months, Severe dyspnea, Severe side effects, Sodium fluoride, Starnberg, Steroid, Steroid aerosols, Teratoma, Thoracic skin.
Abstract
Summary: A 77-year-old man with chronic obstructive pulmonary disease was treated with low-dose methotrexate (7.5–15 mg per week). After 15 months a diagnosis of urothelial carcinoma of the bladder was made; after a further 6 months pneumonitis and pancytopenia developed. The patient died due to massive pulmonary hemorrhage. A malignant teratoma was diagnosed in a 65-year-old asthmatic man 16 months after initiation of methotrexate therapy (15 mg per week). The patient died 4 months later due to fulminant progression of the neoplasm. A third malignant neoplasm (dermal squamous cell carcinoma) was seen in a 64-year-old woman with rheumatoid arthritis after 13 months treatment with 7.5 mg methotrexate per week. These three cases, while obviously not proving a causal relationship between long-term treatment with low-dose methotrexate and development of malignant neoplasm, do call for stringent treatment criteria, close surveillance, and prospective studies.
Url:
DOI: 10.1007/BF00180446
Affiliations:
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<term>Arthritis</term>
<term>Asthma</term>
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<term>Bladder</term>
<term>Bowel disease</term>
<term>Carcinogenicity</term>
<term>Causal relationship</term>
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<term>Drug interactions</term>
<term>Dyspnea</term>
<term>Lung disease</term>
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<term>Mediastinal</term>
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<term>Methotrexate therapy</term>
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<term>Pancytopenia</term>
<term>Pneumonitis</term>
<term>Psoriasis</term>
<term>Psoriatic arthritis</term>
<term>Pulmonary disease</term>
<term>Renal</term>
<term>Renal function</term>
<term>Rheumatoid</term>
<term>Rheumatoid arthritis</term>
<term>Risk factors</term>
<term>Several months</term>
<term>Severe dyspnea</term>
<term>Severe side effects</term>
<term>Sodium fluoride</term>
<term>Starnberg</term>
<term>Steroid</term>
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<front><div type="abstract" xml:lang="en">Summary: A 77-year-old man with chronic obstructive pulmonary disease was treated with low-dose methotrexate (7.5–15 mg per week). After 15 months a diagnosis of urothelial carcinoma of the bladder was made; after a further 6 months pneumonitis and pancytopenia developed. The patient died due to massive pulmonary hemorrhage. A malignant teratoma was diagnosed in a 65-year-old asthmatic man 16 months after initiation of methotrexate therapy (15 mg per week). The patient died 4 months later due to fulminant progression of the neoplasm. A third malignant neoplasm (dermal squamous cell carcinoma) was seen in a 64-year-old woman with rheumatoid arthritis after 13 months treatment with 7.5 mg methotrexate per week. These three cases, while obviously not proving a causal relationship between long-term treatment with low-dose methotrexate and development of malignant neoplasm, do call for stringent treatment criteria, close surveillance, and prospective studies.</div>
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