Methotrexate induced sprue- like disease in a psoriatic patient: A rare case report

“Drug – induced” or “medicationrelated” forms of enteropathy are known to result in alterations in small intestinal architecture and function causing “spruelike” mucosal changes, diarrhoea and malabsorption. Many drugs are proved to induce these changes and these include chemotherapeutic agents like colchicine, vincristine, and immunosuppresants like methotrexate, azathioprine, mycophenolate mofetil [1]. Several cases of villous atrophy following use of immunosuppresants are reported. But, literature search revealed only two cases of intestinal villous atrophy secondary to methotrexate [2]. We present this third case of spruelike syndrome secondary to methotrexate treatment in a psoriatic patient.