Guevara Nehemias A, Hernandez Tabata E, Rosado Flor, Gupta Sorab
Internal Medicine, SBH (St. Barnabas Hospital) Health System, Bronx, USA.
Oncology, Albert Einstein College of Medicine, Bronx, USA.
Cureus. 2023 Jun 11;15(6):e40257. doi: 10.7759/cureus.40257. eCollection 2023 Jun.
Methotrexate (MTX) is a crucial part of the management of rheumatoid arthritis (RA). Although MTX is generally well tolerated, it is not exempt from adverse effects. The side effects of MTX are diverse, and pericarditis, as demonstrated in our case, is one of the rarest adverse effects. Therefore, it is crucial to rule out common causes of pericarditis, such as infections, malignancies, or other underlying conditions. However, once common causes are excluded, MTX-induced pericarditis should always be considered, and MTX should be discontinued without resumption due to potential relapse. Furthermore, the timing of MTX initiation is not significant; patients may have been on chronic MTX treatment or have recently started it. Moreover, pericarditis secondary to MTX is not exclusive to patients with rheumatological conditions but can also occur in other conditions.
甲氨蝶呤（MTX）是类风湿关节炎（RA）治疗的关键部分。尽管MTX通常耐受性良好，但它并非没有副作用。MTX的副作用多种多样，正如我们病例中所显示的，心包炎是最罕见的副作用之一。因此，排除心包炎的常见病因，如感染、恶性肿瘤或其他潜在疾病至关重要。然而，一旦排除了常见病因，应始终考虑MTX诱导的心包炎，并且由于潜在的复发，不应恢复使用MTX。此外，MTX开始使用的时间并不重要；患者可能一直在接受慢性MTX治疗，或者最近才开始使用。此外，MTX继发的心包炎并非仅限于患有风湿性疾病的患者，也可能发生在其他疾病中。
