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Methotrexate osteopathy in rheumatic disease.
  1. S J Preston,
  2. T Diamond,
  3. A Scott,
  4. M R Laurent
  1. Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.

    Abstract

    OBJECTIVE--To determine whether two adults with stress fractures receiving low weekly doses of methotrexate had methotrexate osteopathy. CASE REPORTS--Two adult patients developed features consistent with methotrexate osteopathy while receiving low weekly doses of methotrexate. METHODS--Iliac crest biopsy samples were taken and bone histomorphometry carried out. RESULTS--Symptoms resolved when the methotrexate was discontinued. Bone histology showed changes consistent with osteoblast inhibition by methotrexate. CONCLUSIONS--When given in low doses for prolonged periods, methotrexate may have adverse effects on bone, particularly in post-menopausal women.

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