Palabras clave
Metotrexato
Artritis reumatoide
Categorías
Cómo citar
Resumen
Antecedentes: Los pacientes con artritis reumatoide (AR) tratados con metotrexato (MTX) presentar mielosupresión, leucopenia, trombocitopenia y anemia megaloblástica. La toxicidad hematológica provoca que los pacientes interrumpan el tratamiento debido al riesgo de mortalidad. Caso clínico: Paciente femenino de 70 años con diagnóstico de AR, acude con astenia, adinamia, fiebre nocturna y dolor en la mucosa oral; con hemoglobina de 7.5g/dL, leucocitos 1700µl y plaquetas de 13,000/mm3. La paciente es diagnosticada con mielosupresión secundaria a MTX se maneja con hemoderivados, hidratación, ácido folinico, factor estimulador de colonias de granulocitos rHu-G-CSF y glicopreoteina recombinante. Conclusiones: El MTX es eficaz en el tratamiento de la AR, su uso indebido, en adultos mayores, puede causar efectos secundarios graves, como toxicidad hematológica y riesgo de infecciones. El manejo de la mielosupresión secundaria a MTX tiene tres objetivos, eliminación del metotrexato del torrente sanguíneo, terapia con ácido folínico y tratamiento enfocado en la pancitopenia.
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Derechos de autor 2024 Marisol Silva-Vera, Xochitl Viridiana Piña-Padilla, María de Jesús Jiménez-González, Raul Fernando Guerrero-Castañeda