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William A. Burke, MD; Billy E. Jones, MD
East Carolina University School of Medicine Greenville, NC

JAMA. 1988;260(20):3003-3004.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Drs Shupack and Webster¹ recently reported two patients with pancytopenia following low-dose methotrexate therapy for psoriasis. The authors state that "because there is as yet no clear explanation for pancytopenia due to low-dose methotrexate, it is difficult to make authoritative recommendations for its prevention." However, the authors fail to mention whether a folate level was obtained on these patients to ensure that folic acid deficiency was not a cause of their pancytopenia. We recently saw a patient with refractory psoriasis who developed a similar case of pancytopenia several weeks after beginning oral methotrexate therapy at 15 mg/wk.

Report of Cases.—CASE 1.—

A 53-year-old man had been treated in the past with up to 50 mg of intramuscular methotrexate per week without complications. Renal and liver parameters were normal, and a liver biopsy revealed only grade I (mild portal inflammation) changes. The red blood cell . . . [Full Text PDF of this Article]

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