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Alan Menter, MD; Alan S. Boyd, MD
Baylor University Medical Center Dallas

JAMA. 1988;260(20):3004-3005.

	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.—

In the June 24 issue of THE JOURNAL, two cases of pancytopenia related to low-dose methotrexate therapy for psoriasis were reported.¹ The opening paragraph of this report has the following sentence: "With the exception of the need for periodic biopsy of the liver and the avoidance of alcohol,¹ it is a simple, easily complied-with regimen for often disabling disease." This is misleading and a major oversimplification of the care needed, both by physician and patient, in using this potentially dangerous drug. In reviewing the two patients' case reports, we were struck by the fact that neither should have continued or possibly even been given methotrexate therapy. The first patient continued to have "... mild thrombocytopenia in temporal relation to methotrexate therapy on several occasions," suggesting a possibly idiosyncratic response to methotrexate. The second patient's medical history was "... notable for alcoholic liver disease."

As discussed in the . . . [Full Text PDF of this Article]

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