Hypoplastic Myelodysplastic Syndrome: Symptom of Methotrexate Toxicity in Rheumatoid Arthritis

Methotrexate is the conventional disease-modifying anti-rheumatic drug (DMARD) which considered of choice in treatment rheumatoid arthritis, but its prolonged use without monitoring leads to a number complications involving different body systems. The toxic effects long-term methotrexate (MTX) therapy mainly involve liver, skin, gastrointestinal tract (GIT) and bone marrow. In marrow, it causes suppression normal functionality, leading formation abnormal blast cells dysplasia. this case report, we present male patient with symptoms hoarseness, fatigue bleeding all can be affiliated methotrexate-induced hypoplastic myelodysplasia. As pancytopenia lethal complication MTX toxicity, important monitor dosage so that any unforeseen development vital steps may taken diagnose treat time. Regarding our patient, after thorough history taking undergoing extensive hematological workup, diagnosis MTX-induced myelodysplasia was made. His improved on withholding from his active regimen adding folinic acid colony-stimulating factors.