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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Case Report

Severe Pancytopenia Following Single Dose Methotrexate In Psoriasis: A Rare And Potentially Lethal Manifestation

Author(s): Ajeet Singh*, Ritul Choudhary, Namrata Chhabra, Satyaki Ganguly and Vinay Rathore

Volume 16, Issue 1, 2021

Published on: 26 October, 2020

Page: [110 - 113] Pages: 4

DOI: 10.2174/1574886315666201026125149

Price: $65

Abstract

Methotrexate is an anti-metabolite, anti-cancer drug frequently used in the treatment of extensive chronic plaque psoriasis. Psoriatic plaque erosion is a rare toxic side effect of single-dose methotrexate and is described as a sign of impending pancytopenia. Here, we report a case of a 48- year-old male presented with multiple oral and genital erosions, accompanied by fissuring over palm and soles for 5 days. His laboratory tests revealed severe pancytopenia and nephropathy. He had a history of chronic plaque psoriasis for which he took a single dose of 15 mg methotrexate. During the hospital stay, the patient needed folate antagonist, granulocyte colony-stimulating factor (G-CSF), intravenous fluids, blood transfusions, and platelet transfusions. He recovered within 12 days of admission.

Keywords: Psoriatic, acute methotrexate toxicity, pancytopenia, nephropathy, blood transfusions, granulocyte colony stimulating factor.

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Graphical Abstract

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