Methotrexate and oral ulceration

Deeming, G M J; Collingwood, James; Pemberton, M. N.

doi:10.1038/sj.bdj.4811972

Cited by 67 publications

(46 citation statements)

References 15 publications

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“…However, methotrexate is related to well recognize adverse effects that may complicate patient's clinical condition. Amongst them, oral ulcerations and sore mouth are quite common, are dose dependent and may appear at any time during the course of methotrexate treatment [21,22]. Therefore, oral ulcers developing in T-LGL leukemia patients receiving methotrexate, including our patient, may also be related to methotrexate regimen and may be benefited by temporary methotrexate discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report

Arvanitidou¹,

Nikitakis²,

Sklavounou

2011

JOMR

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BackgroundT-cell large granular lymphocytic (T-LGL) leukemia is a rare, chronic, often indolent lymphoproliferative disorder of mature T cells (CD3+). Severe neutropenia and other cytopenias are common features in patients with T-LGL leukemia and may cause infections, thus representing a major cause of morbidity in this disease. Immunosuppressive therapy with low-dose regimes of methotrexate, cyclophosphamide, corticosteroids or cyclosporine A is the treatment of choice. Amongst the variety of T-LGL leukemia complications, oral manifestations such as ulcers have been rarely reported. The purpose of this paper is to report a case of T-cell large granular lymphocyte leukemia with oral manifestations and to discuss their pathogenesis and management.MethodsIn the present case, a 65 year old female with a two-month history of diagnosed T-LGL leukemia presented with oral lesions, including ulcerations on the ventral tongue and soft palate as well as swollen, erythematous and ulcerated gingiva. The patient was under treatment with methotrexate, granulocyte colony-stimulating factor (G-CSF) and erythropoietin.ResultsConsidering patients' medical history and clinical appearance of the lesions, a clinical diagnosis of a neutropenic ulcer of the tongue was established. The oral lesions resolved after treatment with antibiotics, topical steroids and antiseptics combined with improvement of the hematological condition. The pertinent literature related to T-LGL leukemia ethiopathology, diagnostics and treatment was discussed.ConclusionsAlthough rare, T-cell large granular lymphocytic leukemia should be included in the list of lymphoproliferative disorders, which may present with oral manifestations as a result of the disease and its treatment complications.

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Section: Discussionmentioning

confidence: 99%

Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report

Arvanitidou¹,

Nikitakis²,

Sklavounou

2011

JOMR

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“…Depletion of tetrahydrofolic acid leads to a decreased thymidylate and purine biosynthesis, resulting in a decreased DNA synthesis. This effect on reducing DNA formation and cell turnover is responsible for both the therapeutic effect and the more common side effects [3].…”

Section: Introductionmentioning

confidence: 99%

Effects of Kurdistan Honey on the Tongue of Chemotherapy Treated Albino Rats (Immunohistochemical Study)

Refai¹

2014

J Cytol Histol

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“…Very few reports have provided histological analysis of oral lesions induced by LDMTX therapy (5)(6)14). Kalantzis et al (6).…”

Section: Discussionmentioning

confidence: 99%

“…For the treatment of oral lesions resulting from LDMTX therapy, use of traditional agents such as topical analgesics or steroids, mouthwash and covering agents have been reported (5). However, these agents appear to provide only symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

Oral ulceration due to an antirheumatic drug (methotrexate): Report of a case

et al. 2008

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Abstract:We report a case of oral ulceration that occurred during the course of rheumatoid arthritis treated with methotrexate. The patient was a 71-year-old man with oral ulceration of the floor of the mouth. The ulcer showed no induration, with a flat, clean surface and no bleeding. Biopsy revealed ulcer formation with marked inflammatory cell infiltration in the submucosa and dysplasia-like changes in epithelium. Topical steroids were ineffective. After reducing the dose of methotrexate, we observed that the lesion had epithelialized. The oral toxicity of low-dose methotrexate therapy is discussed.

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Methotrexate and oral ulceration

Cited by 67 publications

References 15 publications

Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report

Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report

Effects of Kurdistan Honey on the Tongue of Chemotherapy Treated Albino Rats (Immunohistochemical Study)

Oral ulceration due to an antirheumatic drug (methotrexate): Report of a case

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