甲氨蝶呤(Methotrexate)誘導早發性泛血球低下症－－兩病例報告

Methotrexate-induced Early Onset Pancytopenia-- Two Cases Report

低劑量脈衝式甲氨蝶呤用於類風濕性關節炎的治療已成為一種廣為流行的抗風濕藥物。雖然這種治療一般而言是有效而且相當安全，但是偶而仍會產生一些嚴重的併發症。在此吾等報告兩位類風濕性關節炎患者，其中一位是七十四歲女性有十年關節炎病史，另一位是四十七歲糖尿病女性有八年關節炎病史。兩者在服用僅僅7.5毫克的甲氨蝶呤後都產生嚴重的泛血球低下症。本文將就相關的危險因素和可能的致病機轉作一探討。

Low dose pulse methotrexate (MTX) has become a popular disease modified anti-rheumatic drug for rheumatoid arthritis (RA). Although this regimen is effective and relatively safe for the treatment of RA, some severe complications may occur occasionally. Here, we describe two patients with RA, one is a 74-year-old female with 10-year history of diseaese, and the other is a 47-year-old diabetic woman with 8-year history of disease. They both developed severe pancytopenia after taking only 7.5mg MTX. We will review the literature and discuss the potential risk factors for this complication.