Accelerated nodulosis during azathioprine therapy

Methotrexate induced accelerated nodulosis.

Methotrexate induced accelerated nodulosis (MIAN) is a rare but unique side effect of methotrexate therapy. There is paucity of data from our country about this entity. We analyzed 14 cases of MIAN and studied its association with gender, rheumatoid factor positivity and dose and duration of methotrexate. Fourteen patients (8 females), 12 with rheumatoid arthritis (8 seropositive), one each wit...

Azathioprine-induced accelerated cutaneous and pulmonary nodulosis in a patient with rheumatoid arthritis*

We report the case of a 42-year-old female with a 5-year history of rheumatoid arthritis treated with Rituximab and Azathioprine. Three months after the initiation of Azathioprine, the patient started with dry cough and noted the rapid development of multiple subcutaneous nodules on her right leg. CT scan of the chest demonstrates pulmonary nodulosis. Skin biopsy was compatible with rheumatoid ...

Myelotoxicity and hepatotoxicity during azathioprine therapy.

Azathioprine is a frequently used immunosuppressant for managing inflammatory bowel disease (IBD). In recent years the hepatotoxic profile of thiopurines has been recognised. We report the case of a 40-year-old man with Crohn's disease treated with azathioprine. After taking azathioprine (2.2 mg/kg daily) for two years, his liver function tests were found to be elevated. Moreover, a myelodepres...

Epstein-Barr virus-associated methotrexate-induced accelerated rheumatoid nodulosis.

Methotrexate-induced accelerated nodulosis in seropositive rheumatoid arthritis.

A 57 year old gentleman presented with multiple nodular swellings over dorsal aspects of hands (Figure 1), forearms (Figure 2), posterior superior iliac spine and over back (Figure 2) for last two weeks. He was diagnosed with seropositive rheumatoid arthritis (rA) 6 months back and was put on weekly subcutaneous methotrexate (MTX) and oral sulphasalazine. The patient did not notice any nodule d...