Table 3

Severely abnormal laboratory abnormalities among 248 patients with rheumatoid arthritis treated with methotrexate

Patient	Severely abnormal value	Clinical action taken	Subsequent tests after severe abnormal values
Patient	Severely abnormal value	Clinical action taken	Duration of follow up (years)	Number of tests	Median value (min, max)
AST, aspartate aminotransferase; MTX, methotrexate; WBC, white blood count.
	AST
1	234	MTX 7.5 to 12.5 mg	0.7	1	12
2	198	MTX 22.5 to 15.0 mg	2.4	5	50 (15, 83)
3	161	None	10.5	22	35 (25, 128)
4	149	MTX stopped for 7 months	3.1	16	32 (23, 91)
5	134	MTX 7.5 to 12.5 mg	6.5	28	23 (14, 41)
6	131	None	4.6	15	60 (24, 141)
7	124	None	2.6	8	56 (44, 96)
8	115	MTX 22.5 to 10 mg	1.1	4	16 (14, 22)
9	108	None	1.6	6	22 (20, 41)

	Albumin
10	28	MTX resumed 7.5 mg	3.2	9	34 (32, 37)
11	28	MTX 7.5 to 15 mg	1.6	6	30 (25, 32)
12	27	Internist informed of abnormalities	4.1	14	34 (26, 41)
13	29	MTX 15 to 7.5 mg	2.5	6	32 (29, 37)
14	29	None	0.7	3	33 (32, 33)
15	28	Patient informed of value and instructed to recheck locally	0.2	3	31 (29, 31)
16	29	None	2.7	6	32 (30, 37)
17	29	None	2.4	4	30 (29, 30)
18	29	None	0.6	2	37 (36, 38)
19	28	None	3.5	10	36 (31, 42)
20	27	Abnormality noted in chart	2.3	7	32 (26, 35)

	WBC
21	2.6	None	4.5	12	4.4 (3.1, 5.8)
22	2.6	MTX 22.5 to 15 mg	1.0	3	4.6 (4.0, 4.7)
15	2.8	Patient informed of value and instructed to recheck locally	0.2	3	7.6 (6.0, 10.6)
23	2.9	None	4.9	13	4.2 (3.5, 8.9)
24	1.9	MTX 10 to 15 mg	1.1	5	2.4 (2.2, 2.8)
25	2.2	None	5.4	17	5.0 (3.2, 8.9)
26	1.6	MTX withheld for one week	2.1	14	6.2 (3.8, 9.1)

	Platelet count
10	87	MTX 7.5 to 15 mg	2.5	7	109 (104, 136)
27	80	None	10.9	35	107 (75, 154)
4	84	None	4.3	16	87 (62, 118)