Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury
Methotrexate is one of the most commonly used drugs in autoimmune disorders like rheumatoid arthritis. Gastrointestinal symptoms like nausea and stomatitis, skin rashes, alopecia, central nervous system symptoms like headache and confusion, hepatotoxicity and myelosuppression are some of the adverse...
Gespeichert in:
| Veröffentlicht in: | BMJ case reports 2018-06, Vol.2018, p.bcr-2018-224722 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | |
| container_start_page | bcr-2018-224722 |
| container_title | BMJ case reports |
| container_volume | 2018 |
| creator | Manappallil, Robin George Prasan, Durga Peringat, Jayameena Biju, Illolil Kuniyil |
| description | Methotrexate is one of the most commonly used drugs in autoimmune disorders like rheumatoid arthritis. Gastrointestinal symptoms like nausea and stomatitis, skin rashes, alopecia, central nervous system symptoms like headache and confusion, hepatotoxicity and myelosuppression are some of the adverse effects. However, low oral doses on a weekly basis seldom show any signs of toxicity. Leucovorin or folinic acid is given along with methotrexate as rescue to reduce the toxic effects like bone marrow suppression. Non-steroidal anti-inflammatory drugs, like aceclofenac, are also used in chronic inflammatory conditions like rheumatoid arthritis and osteoarthritis. Nephrotoxicity is one of the adverse effects of both methotrexate and non-steroidal anti-inflammatory drugs; and its combined administration should be done with caution. This is a case of an elderly woman, a known case of rheumatoid arthritis, who presented in severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury. |
| doi_str_mv | 10.1136/bcr-2018-224722 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5990089</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2050321382</sourcerecordid><originalsourceid>FETCH-LOGICAL-b3972-6ee38c76bf964127965a68aa797f3121559b77ea4a65b710bf822dd1a734988f3</originalsourceid><addsrcrecordid>eNqFkc1LHDEYh0NpqaJ77q0EeiuM5mNmklwKRbQVBA9W8BaSzDua7UyyTWZW9783y65iT-aSr-f95Q0PQl8oOaGUt6fWpYoRKivGasHYB3RIRSMqocjdxzfrA7TIeUnK4LSWNf-MDpiSgqqWHaLxBtaQANsYAI8mpfiI87xaJcjZx4C7GfAU8QjTQ5wSPJlpu3_yzk8b3MdhiI8-3GPjwA2xh2Bc5UM3O-jK2Vzgv74LsME-LOe0OUafejNkWOznI3R7cf7n7Hd1df3r8uznVWW5EqxqAbh0orW9amvKhGob00pjhBI9p4w2jbJCgKlN21hBie0lY11HjeC1krLnR-jHLnc12xE6B2FKZtCr5MsXNzoar_-_Cf5B38e1bpQiRKoS8G0fkOK_GfKkl3FOofSsGWkIZ5RLVqjTHeVSzDlB__oCJXqrSBdFeqtI7xSViq9vG3vlX4QU4PsOsOPy3bRnVUWcdA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2050321382</pqid></control><display><type>article</type><title>Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Manappallil, Robin George ; Prasan, Durga ; Peringat, Jayameena ; Biju, Illolil Kuniyil</creator><creatorcontrib>Manappallil, Robin George ; Prasan, Durga ; Peringat, Jayameena ; Biju, Illolil Kuniyil</creatorcontrib><description>Methotrexate is one of the most commonly used drugs in autoimmune disorders like rheumatoid arthritis. Gastrointestinal symptoms like nausea and stomatitis, skin rashes, alopecia, central nervous system symptoms like headache and confusion, hepatotoxicity and myelosuppression are some of the adverse effects. However, low oral doses on a weekly basis seldom show any signs of toxicity. Leucovorin or folinic acid is given along with methotrexate as rescue to reduce the toxic effects like bone marrow suppression. Non-steroidal anti-inflammatory drugs, like aceclofenac, are also used in chronic inflammatory conditions like rheumatoid arthritis and osteoarthritis. Nephrotoxicity is one of the adverse effects of both methotrexate and non-steroidal anti-inflammatory drugs; and its combined administration should be done with caution. This is a case of an elderly woman, a known case of rheumatoid arthritis, who presented in severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-224722</identifier><identifier>PMID: 29871962</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Acute Kidney Injury - chemically induced ; Aged ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Antirheumatic Agents - adverse effects ; Arthritis, Rheumatoid - drug therapy ; Biomarkers ; Bone marrow ; Bone Marrow Cells - drug effects ; Bone Marrow Diseases - chemically induced ; Cancer therapies ; Case reports ; Diabetes ; Diclofenac - adverse effects ; Diclofenac - analogs & derivatives ; Drug dosages ; Drug Therapy, Combination - adverse effects ; Fatal Outcome ; Female ; Humans ; Intensive care ; Kidneys ; Liver ; Methotrexate - adverse effects ; Mortality ; Oral Ulcer - chemically induced ; Patients ; Physicians ; Psoriasis ; Reminder of Important Clinical Lesson ; Rheumatoid arthritis ; Rheumatology ; Ulcers ; Urine ; Ventilators ; Vitamin B</subject><ispartof>BMJ case reports, 2018-06, Vol.2018, p.bcr-2018-224722</ispartof><rights>BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>Copyright: 2018 © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3972-6ee38c76bf964127965a68aa797f3121559b77ea4a65b710bf822dd1a734988f3</citedby><cites>FETCH-LOGICAL-b3972-6ee38c76bf964127965a68aa797f3121559b77ea4a65b710bf822dd1a734988f3</cites><orcidid>0000-0003-3973-6800</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990089/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990089/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29871962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manappallil, Robin George</creatorcontrib><creatorcontrib>Prasan, Durga</creatorcontrib><creatorcontrib>Peringat, Jayameena</creatorcontrib><creatorcontrib>Biju, Illolil Kuniyil</creatorcontrib><title>Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>Methotrexate is one of the most commonly used drugs in autoimmune disorders like rheumatoid arthritis. Gastrointestinal symptoms like nausea and stomatitis, skin rashes, alopecia, central nervous system symptoms like headache and confusion, hepatotoxicity and myelosuppression are some of the adverse effects. However, low oral doses on a weekly basis seldom show any signs of toxicity. Leucovorin or folinic acid is given along with methotrexate as rescue to reduce the toxic effects like bone marrow suppression. Non-steroidal anti-inflammatory drugs, like aceclofenac, are also used in chronic inflammatory conditions like rheumatoid arthritis and osteoarthritis. Nephrotoxicity is one of the adverse effects of both methotrexate and non-steroidal anti-inflammatory drugs; and its combined administration should be done with caution. This is a case of an elderly woman, a known case of rheumatoid arthritis, who presented in severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury.</description><subject>Acute Kidney Injury - chemically induced</subject><subject>Aged</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Antirheumatic Agents - adverse effects</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biomarkers</subject><subject>Bone marrow</subject><subject>Bone Marrow Cells - drug effects</subject><subject>Bone Marrow Diseases - chemically induced</subject><subject>Cancer therapies</subject><subject>Case reports</subject><subject>Diabetes</subject><subject>Diclofenac - adverse effects</subject><subject>Diclofenac - analogs & derivatives</subject><subject>Drug dosages</subject><subject>Drug Therapy, Combination - adverse effects</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Liver</subject><subject>Methotrexate - adverse effects</subject><subject>Mortality</subject><subject>Oral Ulcer - chemically induced</subject><subject>Patients</subject><subject>Physicians</subject><subject>Psoriasis</subject><subject>Reminder of Important Clinical Lesson</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatology</subject><subject>Ulcers</subject><subject>Urine</subject><subject>Ventilators</subject><subject>Vitamin B</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1LHDEYh0NpqaJ77q0EeiuM5mNmklwKRbQVBA9W8BaSzDua7UyyTWZW9783y65iT-aSr-f95Q0PQl8oOaGUt6fWpYoRKivGasHYB3RIRSMqocjdxzfrA7TIeUnK4LSWNf-MDpiSgqqWHaLxBtaQANsYAI8mpfiI87xaJcjZx4C7GfAU8QjTQ5wSPJlpu3_yzk8b3MdhiI8-3GPjwA2xh2Bc5UM3O-jK2Vzgv74LsME-LOe0OUafejNkWOznI3R7cf7n7Hd1df3r8uznVWW5EqxqAbh0orW9amvKhGob00pjhBI9p4w2jbJCgKlN21hBie0lY11HjeC1krLnR-jHLnc12xE6B2FKZtCr5MsXNzoar_-_Cf5B38e1bpQiRKoS8G0fkOK_GfKkl3FOofSsGWkIZ5RLVqjTHeVSzDlB__oCJXqrSBdFeqtI7xSViq9vG3vlX4QU4PsOsOPy3bRnVUWcdA</recordid><startdate>20180605</startdate><enddate>20180605</enddate><creator>Manappallil, Robin George</creator><creator>Prasan, Durga</creator><creator>Peringat, Jayameena</creator><creator>Biju, Illolil Kuniyil</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3973-6800</orcidid></search><sort><creationdate>20180605</creationdate><title>Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury</title><author>Manappallil, Robin George ; Prasan, Durga ; Peringat, Jayameena ; Biju, Illolil Kuniyil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3972-6ee38c76bf964127965a68aa797f3121559b77ea4a65b710bf822dd1a734988f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute Kidney Injury - chemically induced</topic><topic>Aged</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Antirheumatic Agents - adverse effects</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biomarkers</topic><topic>Bone marrow</topic><topic>Bone Marrow Cells - drug effects</topic><topic>Bone Marrow Diseases - chemically induced</topic><topic>Cancer therapies</topic><topic>Case reports</topic><topic>Diabetes</topic><topic>Diclofenac - adverse effects</topic><topic>Diclofenac - analogs & derivatives</topic><topic>Drug dosages</topic><topic>Drug Therapy, Combination - adverse effects</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Kidneys</topic><topic>Liver</topic><topic>Methotrexate - adverse effects</topic><topic>Mortality</topic><topic>Oral Ulcer - chemically induced</topic><topic>Patients</topic><topic>Physicians</topic><topic>Psoriasis</topic><topic>Reminder of Important Clinical Lesson</topic><topic>Rheumatoid arthritis</topic><topic>Rheumatology</topic><topic>Ulcers</topic><topic>Urine</topic><topic>Ventilators</topic><topic>Vitamin B</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manappallil, Robin George</creatorcontrib><creatorcontrib>Prasan, Durga</creatorcontrib><creatorcontrib>Peringat, Jayameena</creatorcontrib><creatorcontrib>Biju, Illolil Kuniyil</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manappallil, Robin George</au><au>Prasan, Durga</au><au>Peringat, Jayameena</au><au>Biju, Illolil Kuniyil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2018-06-05</date><risdate>2018</risdate><volume>2018</volume><spage>bcr-2018-224722</spage><pages>bcr-2018-224722-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>Methotrexate is one of the most commonly used drugs in autoimmune disorders like rheumatoid arthritis. Gastrointestinal symptoms like nausea and stomatitis, skin rashes, alopecia, central nervous system symptoms like headache and confusion, hepatotoxicity and myelosuppression are some of the adverse effects. However, low oral doses on a weekly basis seldom show any signs of toxicity. Leucovorin or folinic acid is given along with methotrexate as rescue to reduce the toxic effects like bone marrow suppression. Non-steroidal anti-inflammatory drugs, like aceclofenac, are also used in chronic inflammatory conditions like rheumatoid arthritis and osteoarthritis. Nephrotoxicity is one of the adverse effects of both methotrexate and non-steroidal anti-inflammatory drugs; and its combined administration should be done with caution. This is a case of an elderly woman, a known case of rheumatoid arthritis, who presented in severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29871962</pmid><doi>10.1136/bcr-2018-224722</doi><orcidid>https://orcid.org/0000-0003-3973-6800</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1757-790X |
| ispartof | BMJ case reports, 2018-06, Vol.2018, p.bcr-2018-224722 |
| issn | 1757-790X 1757-790X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5990089 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Acute Kidney Injury - chemically induced Aged Anti-Inflammatory Agents, Non-Steroidal - adverse effects Antirheumatic Agents - adverse effects Arthritis, Rheumatoid - drug therapy Biomarkers Bone marrow Bone Marrow Cells - drug effects Bone Marrow Diseases - chemically induced Cancer therapies Case reports Diabetes Diclofenac - adverse effects Diclofenac - analogs & derivatives Drug dosages Drug Therapy, Combination - adverse effects Fatal Outcome Female Humans Intensive care Kidneys Liver Methotrexate - adverse effects Mortality Oral Ulcer - chemically induced Patients Physicians Psoriasis Reminder of Important Clinical Lesson Rheumatoid arthritis Rheumatology Ulcers Urine Ventilators Vitamin B |
| title | Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T21%3A26%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Severe%20bone%20marrow%20suppression%20due%20to%20methotrexate%20toxicity%20following%20aceclofenac-induced%20acute%20kidney%20injury&rft.jtitle=BMJ%20case%20reports&rft.au=Manappallil,%20Robin%20George&rft.date=2018-06-05&rft.volume=2018&rft.spage=bcr-2018-224722&rft.pages=bcr-2018-224722-&rft.issn=1757-790X&rft.eissn=1757-790X&rft_id=info:doi/10.1136/bcr-2018-224722&rft_dat=%3Cproquest_pubme%3E2050321382%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2050321382&rft_id=info:pmid/29871962&rfr_iscdi=true |