Agarwal V, Aggarwal Amita, Misra R
Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Assoc Physicians India. 2004 Jul;52:538-40.
Methotrexate induced accelerated nodulosis (MIAN) is a rare but unique side effect of methotrexate therapy. There is paucity of data from our country about this entity. We analyzed 14 cases of MIAN and studied its association with gender, rheumatoid factor positivity and dose and duration of methotrexate. Fourteen patients (8 females), 12 with rheumatoid arthritis (8 seropositive), one each with juvenile idiopathic (JIA) and psoriatic arthritis (PsA) were detected to have MIAN during study period. All the patients presented with acute onset of multiple nodules. Radial border of fingers was the most commonly involved site. Disease was inactive in all but two patients at the time of appearance of MIAN. There was no association of MIAN with gender, rheumatoid factor positivity, disease duration, cumulative dose and duration of methotrexate therapy. Two patients each were treated with colchicine, D-penicillamine or hydroxy-chloroquine for 3-6 months without any response. We conclude that MIAN is a benign side effect of methotrexate treatment.
甲氨蝶呤诱发的结节病加速（MIAN）是甲氨蝶呤治疗一种罕见但独特的副作用。我国关于该病症的数据较少。我们分析了14例MIAN病例，并研究了其与性别、类风湿因子阳性以及甲氨蝶呤剂量和疗程的关系。在研究期间，检测到14例患者（8名女性）患有MIAN，其中12例为类风湿关节炎（8例血清阳性），1例幼年特发性关节炎（JIA），1例银屑病关节炎（PsA）。所有患者均表现为多个结节急性起病。手指桡侧缘是最常受累部位。除两名患者外，MIAN出现时所有患者的病情均处于非活动期。MIAN与性别、类风湿因子阳性、病程、甲氨蝶呤治疗的累积剂量和疗程均无关联。两名患者分别接受秋水仙碱、青霉胺或羟氯喹治疗3 - 6个月，均无反应。我们得出结论，MIAN是甲氨蝶呤治疗的一种良性副作用。
