Secondary haemophagocytic lymphohistiocytosis vs methotrexate toxicity – a diagnostic conundrum-Reference-Cited by-同舟云学术

Secondary haemophagocytic lymphohistiocytosis vs methotrexate toxicity – a diagnostic conundrum

Published:2023-04 Issue:4 Volume:14 Page:205427042311558
ISSN:2054-2704
Container-title:JRSM Open
language:en
Short-container-title:JRSM Open

Author:

Hawkins Leah¹^ORCID,Gibbs Jack¹,MacMillan Connor¹

Affiliation:

1. Derriford Hospital, University of Plymouth and University Hospitals Plymouth NHS Trust, Plymouth, UK

Abstract

Summary A 74-year-old female with a background of rheumatoid arthritis, managed with weekly methotrexate, was admitted with; oedema, dyspnoea, cachexia and jaundice. Bloods revealed pancytopenia, hyperferritinaemia, hyperbilirubinaemia, hypoalbuminaemia and hypofolataemia. Imaging showed a large right-sided pleural effusion, requiring therapeutic aspiration, and splenomegaly. Bone marrow aspirate revealed haemophagocytosis. Differential diagnoses included methotrexate toxicity (MTXT) and haemophagocytic lymphohistiocytosis (HLH). Management was initiated for MTXT whilst ongoing investigation for possible HLH continued.

Publisher

SAGE Publications

Subject

Ocean Engineering

Link

http://journals.sagepub.com/doi/pdf/10.1177/20542704231155815

Reference10 articles.

1. Methotrexate an Old Drug with New Tricks

2. Methotrexate and its mechanisms of action in inflammatory arthritis

3. Methotrexate Toxicity During Treatment of Chronic Plaque Psoriasis: A Case Report and Review of the Literature

4. Hemophagocytic Lymphohistiocytosis - NORD (National Organization for Rare Disorders). 2022. Available from: https://rarediseases.org/rare-diseases/hemophagocytic-lymphohistiocytosis/ (accessed 2nd January 2023)

Cited by 1 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Methotrexate;Reactions Weekly;2023-05-13