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Title: Early onset methotrexate-induced pancytopenia and response to G-CSF: A report of two cases
Authors: Yoon, K.H. 
Ng, S.C.
Keywords: Early onset
Granulocyte colony-stimulating factor
Rheumatoid arthritis
Issue Date: 2001
Source: Yoon, K.H., Ng, S.C. (2001). Early onset methotrexate-induced pancytopenia and response to G-CSF: A report of two cases. Journal of Clinical Rheumatology 7 (1) : 17-20. ScholarBank@NUS Repository.
Abstract: Methotrexate (MTX) is one of the most widely used antirheumatic drugs for the treatment of rheumatoid arthritis. Whereas the hepatotoxicity of methotrexate is well recognized, the hematologic toxicity, namely, pancytopenia, is still a concern and is potentially fatal. We report two cases of early-onset methotrexate-induced pancytopenia that were successfully treated with granulocyte colony-stimulating factor (G-CSF). The pancytopenia improved with 3 days of administration. A review of the literature revealed at least 146 reported cases of MTX-induced pancytopenia. Significant risk factors for myelotoxicity included renal impairment, infection, and hypoalbuminemia. Successful management includes prompt discontinuation of MTX, intravenous folinic acid, high-dose steroids and, as in our case, G-CSF.
Source Title: Journal of Clinical Rheumatology
ISSN: 10761608
Appears in Collections:Staff Publications

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