Leukoencephalopathy in a patient taking low dose oral methotrexate therapy for rheumatoid arthritis.
Leukoencephalopathy in a patient taking low dose oral methotrexate therapy for rheumatoid arthritis.
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接受低剂量口服甲氨蝶呤治疗类风湿性关节炎的患者出现白质脑病。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
McNeil Jd
中科院分区：
文献类型：
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作者：
Worthley Sg;McNeil Jd
我们描述了一名男子的病例，该男子在每周接受低剂量口服甲氨蝶呤 (MTX) 治疗类风湿性关节炎时，患上白质脑病的痴呆症。磁共振成像和计算机断层扫描所见的白质变化与接受静脉或鞘内甲氨蝶呤治疗的患者报告的白质脑病病例相同。广泛的调查排除了白质疾病的其他已知原因。尽管停止MTX治疗后，他的精神状态无论主观还是客观都没有改善，但仍保持稳定。我们认为，这可能代表口服 MTX 诱发白质脑病的病例，此前尚未有报道。
We describe the case of a man who developed a dementing illness with leukoencephalopathy while receiving low dose weekly oral methotrexate (MTX) therapy for rheumatoid arthritis. The white matter changes seen on magnetic resonance imaging and computerized tomogram scan were the same as those seen in cases of leukoencephalopathy that have been reported in patients receiving intravenous or intrathecal methotrexate. Extensive investigation excluded other known causes of white matter disease. Although no improvement either subjectively or objectively occurred in his mental status after cessation of treatment with MTX, he has remained stable. We believe that this may represent a case of oral MTX induced leukoencephalopathy, which has not previously been reported.