PDF(Pubmed)
Abstract：
Methotrexate (MTX), a commonly used disease-modifying antirheumatic drug, is generally considered safe at low cumulative doses. However, severe pancytopenia can occur even with doses as low as 10 mg, as illustrated by a fatal case in an older adult with chronic kidney disease (CKI) and vitamin B12 deficiency. Despite the low dose and lack of folate supplementation, the patient developed severe mucositis and pancytopenia leading to fatal complications. This case underscores the challenges in diagnosing and managing MTX-induced pancytopenia, especially in patients with comorbidities such as CKI and vitamin B12 deficiency.
摘要：
甲氨蝶呤(MTX),一种常用的缓解疾病的抗风湿药，通常认为在低累积剂量下是安全的。然而,即使剂量低至10毫克，也可能发生严重的全血细胞减少症，如一个患有慢性肾脏疾病（CKI）和维生素B12缺乏的老年人的致命病例所示。尽管低剂量和缺乏叶酸补充剂，患者出现严重的黏膜炎和全血细胞减少，导致致命的并发症。该病例强调了诊断和治疗MTX诱导的全血细胞减少症的挑战，尤其是患有CKI和维生素B12缺乏等合并症的患者。
