METHOTREXATE引起全血球減少症：病例報告

Methotrexate-induced Severe Pancytopenia in One Patient with Rheumatoid Arthritis

低劑量METHOTREXARE已廣泛使用於治療較嚴重的類風濕關節炎。其常見的副作用有腸胃道症狀、肝毒性、口腔潰瘍、白血球減少症等。全血球減少症是少見的副作用。而引起全血球減少症的危險因素有腎功能不全、老年人、低白蛋白血症、併用trimethoprim-sulfamethoxazole等。我們的個案為腎功能不全的類風濕關節炎患者，僅服用5mg的MTX即發生嚴重口腔潰瘍，並在兩過後發生全血球減少症。最後在G-CSF的治療下，病人的全血球減少症於三天後恢復。

A 67 years old female patient with rheumatoid arthritis developed severe mucositis and pancytopenia after receiving 5mg of oral methotrexate (2.5mg/tab). Risk factors for pancytopenia in this patient included impaired renal function, hypoalbuminemia, advanced age. Besides, pancytopenia related eosinophilia was observed. Hematological recovery was noted on the 3rd day of admission after granulocyte-colony-stimulating factor (GCSF) administration.