Accelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis |
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Authors: | R Segal D Caspi M Tishler B Fishel M Yaron |
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Affiliation: | Department of Rheumatology, Ichilov Hospital, Tel Aviv University, Sackler Faculty of Medicine, Israel. |
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Abstract: | Three women with classic rheumatoid arthritis, who were receiving weekly doses of methotrexate (MTX), developed accelerated subcutaneous nodulosis, despite good response to the drug. In 2 of the patients, the onset of nodulosis occurred within 3 months and 5 months, respectively, after starting MTX; in the third patient, it was observed only after 4 years of MTX therapy. In all 3 patients, the onset was unusually abrupt, with extensive distribution and remarkable nodule size. Additional manifestations of cutaneous vasculitis in 2 of the patients and Raynaud's phenomenon in the third appeared concomitantly with the nodulosis. Physicians prescribing MTX therapy for patients with rheumatoid arthritis should be aware of these potential complications. |
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