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Immunoglobulin and lymphocyte decrease concurrent with adverse reactions induced by methotrexate for RA
  1. SHIGEKO INOKUMA,
  2. HAJIME KONO,
  3. HISANORI NAKAYAMA,
  4. JUNKO YAMAZAKI
  1. Department of Allergy and Immunological Diseases
  2. Tokyo Metropolitan Komagome Hospital
  3. Tokyo, Japan
  1. Dr Shigeko Inokuma, Tokyo Metropolitan Komagome Hospital, 3–18–22 Honkomagome, Bunkyoku, Tokyo, 113–8677, Japan

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The limiting factor in low dose pulse methotrexate treatment for rheumatoid arthritis (RA) has been its toxicity.1 ,2We recently treated a female patient with RA, in whom pneumonitis and granulocytopenia developed during methotrexate treatment; her white blood cell count was 1.10×109/l and Pao 2 was 37 mm Hg. Before treatment, at the time of development of adverse reactions, and after recovery after methotrexate was withdrawn, her IgG levels were 17.99, 10.15, 16.75 g/l; IgA 5.14, 3.69, 4.33 g/l; IgM 1.73, 1.06, 1.36 g/l; and lymphocyte count 1.96, 0.42, 1.56×109/l, respectively. We then investigated whether immunoglobulin levels and lymphocyte count decrease when adverse reactions to methotrexate treatment develop.

One hundred consecutive patients with RA (80 women and 20 men, mean (SD) age 57.5 (9.2) years) receiving between 2.5 and 15 mg of methotrexate weekly in Tokyo Metropolitan Komagome Hospital were followed up from 1991 to 1998. When the patients did not respond and …

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  • Email: inokuma-k{at}komagome-hospital.bunkyo.tokyo.jp