Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-med...

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Main Authors: Pankti Jariwala, Vinay Kumar, Khyati Kothari, Sejal Thakkar, Dipak Dayabhai Umrigar
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Dermatological Medicine
Online Access:http://dx.doi.org/10.1155/2014/946716
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author Pankti Jariwala
Vinay Kumar
Khyati Kothari
Sejal Thakkar
Dipak Dayabhai Umrigar
author_facet Pankti Jariwala
Vinay Kumar
Khyati Kothari
Sejal Thakkar
Dipak Dayabhai Umrigar
author_sort Pankti Jariwala
collection DOAJ
description We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.
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spelling doaj-art-f736d528af1a4d93982c91c833bae23b2025-08-20T02:22:49ZengWileyCase Reports in Dermatological Medicine2090-64632090-64712014-01-01201410.1155/2014/946716946716Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of PsoriasisPankti Jariwala0Vinay Kumar1Khyati Kothari2Sejal Thakkar3Dipak Dayabhai Umrigar4Department of Skin & VD, Government Medical College & New Civil Hospital, Surat, Gujarat 395001, IndiaDepartment of Skin & VD, Government Medical College & New Civil Hospital, Surat, Gujarat 395001, IndiaDepartment of Skin & VD, Government Medical College & New Civil Hospital, Surat, Gujarat 395001, IndiaDepartment of Skin & VD, GMERS Medical College & General Hospital, Gotri 202, Wings Ville 41, Arunoday Society, Alkapuri, Vadodara, Gujarat 390001, IndiaDepartment of Skin & VD, Government Medical College & New Civil Hospital, Surat, Gujarat 395001, IndiaWe describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.http://dx.doi.org/10.1155/2014/946716
spellingShingle Pankti Jariwala
Vinay Kumar
Khyati Kothari
Sejal Thakkar
Dipak Dayabhai Umrigar
Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
Case Reports in Dermatological Medicine
title Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
title_full Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
title_fullStr Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
title_full_unstemmed Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
title_short Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis
title_sort acute methotrexate toxicity a fatal condition in two cases of psoriasis
url http://dx.doi.org/10.1155/2014/946716
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