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June 24, 1988, Vol 259, No. 24 >
ARTICLE | June 24, 1988

Pancytopenia Following Low-Dose Oral Methotrexate Therapy for Psoriasis FREE

Jerome L. Shupack, MD; Guy F. Webster, MD, PhD
[+] Author Affiliations

Reprint requests to Department of Dermatology, New York University Medical Center, 550 First Ave, New York, NY 10016 (Dr Shupack).


JAMA. 1988;259(24):3594-3596. doi:10.1001/jama.1988.03720240056034
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References

Low-dose oral methotrexate therapy was associated with the onset of anemia, leukopenia, and thrombocytopenia in two patients with psoriasis. Both patients survived, but required prolonged hospitalization. No precipitating factor other than methotrexate could be identified.

(JAMA 1988;259:3594-3596)

REFERENCES

1 +
Roenigk HH, Auerbach R, Maibach HI, et al:  Methotrexate guidelines—revised. J Am Acad Dermatol 1982;;6:145-155.
2 +
Wilke WS, Biro JA, Segal AM:  Methotrexate in the treatment of arthritis and connective tissue diseases. Cleve Clin J Med 1987;;54:327-338.
3 +
Tugwell P, Bennett K, Gent M:  Methotrexate in rheumatoid arthritis. Ann Intern Med 1987;; 107:358-366.
4 +
MacKinnon SK, Starkebaum G, Wilkins RF:  Pancytopenia associated with low dose pulse methotrexate in the treatment of rheumatoid arthritis. Semin Arthritis Rheum 1985;;15:119-126.
5 +
Groff GD, Shenberger KN, Wilke WS, et al:  Low dose oral methotrexate in rheumatoid arthritis: An uncontrolled trial and review of the literature. Semin Arthritis Rheum 1983;;12:333-347.
6 +
Wilke WS, Calabrese LH, Segal AM:  Incidence of untoward reactions in patients with rheumatoid arthritis treated with methotrexate, abstracted. Arthritis Rheum 1983;;26:556.
7 +
Steinsson K, Weinstein A, Korn J, et al:  Low dose methotrexate in rheumatoid arthritis. J Rheumatol 1982;;9:860-866.
8 +
Hoffmeister RT:  Methotrexate in rheumatoid arthritis: Fifteen years experience. Am J Med 1983;;75:69-73.
9 +
Rees RB, Bennett JH, Maibach HI, et al:  Methotrexate for psoriasis. Arch Dermatol 1967;;95:2-11.
10 +
Van Scott EJ, Auerbach R, Weinstein GD:  Parenteral methotrexate in psoriasis. Arch Dermatol 1964;;89:550-556.
11 +
Roenigk HH, Fowler-Bergfield W, Curtis GH:  Methotrexate for psoriasis in weekly oral doses. Arch Dermatol 1969;;9:86-93.
12 +
Farber EM, Nail ML:  The natural history of psoriasis in 5600 patients. Dermatologica 1974;; 148:1-23.
13 +
Masi AT, Medsger TA:  Epidemiology of the rheumatic diseases , in McCarty DJ Jr (ed): Arthritis and Allied Conditions , ed 9. Philadelphia, Lea & Febiger, 1979;, pp 11-30.
14 +
Schornagel JH, McVie JG:  The clinical pharmacology of methotrexate. Cancer Treat Rev 1983;; 10:53-75.
15 +
Crom WR, Glynn-Barnhart AM, Rodman JH, et al:  Pharmacokinetics of anticancer drugs in children. Clin Pharmacokinet 1987;;12:168-213.
16 +
Clive DM, Stoff JS:  Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med 1984;;310:563-572.
17 +
Frei E, Jaffe N, Tattersall MHN, et al:  New approaches to cancer chemotherapy with methotrexate. N Engl J Med 1975;;292:846-851.
18 +
Taylor JR, Halprin KM:  Effect of sodium salicylate and indomethacin on methotrexate-serum albumin binding. Arch Dermatol 1977;;113:588-591.

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1 +
Roenigk HH, Auerbach R, Maibach HI, et al:  Methotrexate guidelines—revised. J Am Acad Dermatol 1982;;6:145-155.
2 +
Wilke WS, Biro JA, Segal AM:  Methotrexate in the treatment of arthritis and connective tissue diseases. Cleve Clin J Med 1987;;54:327-338.
3 +
Tugwell P, Bennett K, Gent M:  Methotrexate in rheumatoid arthritis. Ann Intern Med 1987;; 107:358-366.
4 +
MacKinnon SK, Starkebaum G, Wilkins RF:  Pancytopenia associated with low dose pulse methotrexate in the treatment of rheumatoid arthritis. Semin Arthritis Rheum 1985;;15:119-126.
5 +
Groff GD, Shenberger KN, Wilke WS, et al:  Low dose oral methotrexate in rheumatoid arthritis: An uncontrolled trial and review of the literature. Semin Arthritis Rheum 1983;;12:333-347.
6 +
Wilke WS, Calabrese LH, Segal AM:  Incidence of untoward reactions in patients with rheumatoid arthritis treated with methotrexate, abstracted. Arthritis Rheum 1983;;26:556.
7 +
Steinsson K, Weinstein A, Korn J, et al:  Low dose methotrexate in rheumatoid arthritis. J Rheumatol 1982;;9:860-866.
8 +
Hoffmeister RT:  Methotrexate in rheumatoid arthritis: Fifteen years experience. Am J Med 1983;;75:69-73.
9 +
Rees RB, Bennett JH, Maibach HI, et al:  Methotrexate for psoriasis. Arch Dermatol 1967;;95:2-11.
10 +
Van Scott EJ, Auerbach R, Weinstein GD:  Parenteral methotrexate in psoriasis. Arch Dermatol 1964;;89:550-556.
11 +
Roenigk HH, Fowler-Bergfield W, Curtis GH:  Methotrexate for psoriasis in weekly oral doses. Arch Dermatol 1969;;9:86-93.
12 +
Farber EM, Nail ML:  The natural history of psoriasis in 5600 patients. Dermatologica 1974;; 148:1-23.
13 +
Masi AT, Medsger TA:  Epidemiology of the rheumatic diseases , in McCarty DJ Jr (ed): Arthritis and Allied Conditions , ed 9. Philadelphia, Lea & Febiger, 1979;, pp 11-30.
14 +
Schornagel JH, McVie JG:  The clinical pharmacology of methotrexate. Cancer Treat Rev 1983;; 10:53-75.
15 +
Crom WR, Glynn-Barnhart AM, Rodman JH, et al:  Pharmacokinetics of anticancer drugs in children. Clin Pharmacokinet 1987;;12:168-213.
16 +
Clive DM, Stoff JS:  Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med 1984;;310:563-572.
17 +
Frei E, Jaffe N, Tattersall MHN, et al:  New approaches to cancer chemotherapy with methotrexate. N Engl J Med 1975;;292:846-851.
18 +
Taylor JR, Halprin KM:  Effect of sodium salicylate and indomethacin on methotrexate-serum albumin binding. Arch Dermatol 1977;;113:588-591.

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