Open AccessAccelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis
Author(s) -
Segal Rafael,
Caspi Dan,
Tishler Moshe,
Fishel Beno,
Yaron Michael
Publication year - 1988
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.1780310915
Subject(s) - rheumatoid arthritis , methotrexate , medicine , vasculitis , dermatology , cutaneous vasculitis , rheumatoid nodule , antirheumatic agents , disease
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.