Preet Singh Yogesh, Aggarwal Amita, Misra Ramnath, Agarwal Vikas
Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Clin Rheumatol. 2007 Jan;26(1):84-7. doi: 10.1007/s10067-006-0301-7. Epub 2006 Apr 25.
Methotrexate (MTX) has gained wide acceptance among both patients and rheumatologists due to its efficacy and safe therapeutic window in a variety of inflammatory rheumatological disorders. However, it has the potential to cause serious, life-threatening complications and even mortality. In the present series, we have reviewed our data of five patients who developed serious pancytopenia after the use of MTX, including one who died. Two of these resulted from prescription errors by primary care physicians. The clinical, laboratory, and outcome profile of all five cases are discussed with a brief review of the literature about MTX-induced pancytopenia. There is an urgent need to increase awareness in primary care physicians, patients, and pharmacists toward informed prescribing, dispensing, and monitoring of MTX to prevent such mishaps in the future.
甲氨蝶呤（MTX）因其在多种炎性风湿性疾病中的疗效和安全治疗窗，已在患者和风湿病学家中获得广泛认可。然而，它有可能引发严重的、危及生命的并发症甚至死亡。在本系列中，我们回顾了5例使用MTX后发生严重全血细胞减少症患者的数据，其中1例死亡。其中2例是由初级保健医生的处方错误导致的。本文讨论了所有5例病例的临床、实验室检查及转归情况，并简要回顾了有关MTX诱导全血细胞减少症的文献。迫切需要提高初级保健医生、患者和药剂师对MTX明智处方、配药和监测的认识，以防止未来发生此类事故。
