Methotrexate Induced Oral Mucositis in Rheuma...

Methotrexate Induced Oral Mucositis in Rheumatoid Arthritis Due to Dosing Error: Implication for Medication Safety and Management

Author Name : Dr Abhishek Sinha, Dr Divya Singh, Dr Kavleen Sethi, Dr Nazish Khan, Dr Shivangi Pandey

ABSTRACT Methotrexate prescriptions for a range of neoplastic conditions are widely known. A once-weekly low-dose regimen is recommended for the treatment of psoriasis and rheumatoid arthritis respectively. In addition to its medicinal benefits, it has a few side effects as well, such as mouth ulcers, which could be caused by overdosing on its once-weekly schedule. This case study details a patient who received methotrexate for rheumatoid arthritis and developed oral mucositis despite having intrinsic methotrexate toxicity. The 59-year-old patient recently diagnosed with rheumatoid arthritis was receiving methotrexate therapy as a part of his treatment plan. The patient, however, unintentionally ingested an excessive dose of methotrexate because of a communication error that occurred during the medication administration process. She started displaying signs of oral mucositis, characterized by uncomfortable ulcers and oral mucosa inflammation, within a short period. The buccal mucosa, labial mucosa and tongue, of the patient's oral cavity displayed numerous ulcerative lesions upon examination. Due to the mucositis's severity, it was challenging to eat, speak, and perform regular oral hygiene procedures.