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Gastroenterology (Expert Forum)
Methotrexate blood problems/existing Crohn's disease
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Methotrexate blood problems/existing Crohn's disease
by lizziecee, Jun 27, 2007 12:00AM
Dx Crohn's 1970.recent dx stricture of small bowel. Taking mtx f 6 years. Bc 2003.Take 12.5mg mtx weekly.Last blood tests show out of range parameters: MCV 102.3,MCH 33.6,serum creatinine 49umol/L.Also take Arimidex,codeine phosphate,folic acid & imodium (immodium).Recent DEXA scan showed osteopenia, bone scan showed rx arthritis,both feet,hands & hips (30 yrs of steroids).Px alendronic acid/Calcichew/vitD.Recently broke no.5 metatarsal bone lfet foot;concerned about osteoporosis too.BC in remission.Concerned continuing mtx indefinitely - gastro will not prescribe any more steroids due to steroid induced psychosis when dx with bc in 2003.Any info on long term mtx side effects? Only info I can find is in the BMJ,June 14,2007,use of mtx for rheumatoid arthritis. Mtx not licensed for Crohn's by mfrs in England, but is available off licence. The mortality figures disconcerting. Only abnormal blood test was 4 yrs ago (before bc dx)with grossly enlarged red cells, prescribed folic acid and no problem until recently.Allergic to Flagyl, sulphur drugs, azathioprine. Would Biologic therapy be an option? (Adalimumab,Certolizumab Pegol).Afraid to stop mtx in case of a Crohn's flare.Had a really bad time on FEC. with severe diarrhea and rectal haemorraghing,faecal incontinence. Lost 28 lbs. Onc pxd small dose of dexamethasone daily, but it didn't help the symptoms much. Appt w/gastro next Wed.Any up to date information if poss. on long term mtx use and mortality stats,future options. options.
Doctor's Answer
by Forum-M.D.-, Jun 28, 2007 12:00AM
The common long-term side effects of MTX are as follows:
* liver - the liver enzymes should be monitored as well as screening for hepatitis
* lung - chronic treatment can lead to lung disease such as inflammatory disease, infection as well as pulmonary lymphomas
* myelosupression and other blood disorders can also be seen in higher instances with chronic use
* kidney damage - also can happen and the creatinine should be monitored if damage is suspected
I would discuss these side effects with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
* liver - the liver enzymes should be monitored as well as screening for hepatitis
* lung - chronic treatment can lead to lung disease such as inflammatory disease, infection as well as pulmonary lymphomas
* myelosupression and other blood disorders can also be seen in higher instances with chronic use
* kidney damage - also can happen and the creatinine should be monitored if damage is suspected
I would discuss these side effects with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Liz.