Copyright
©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 7, 2008; 14(45): 7009-7011
Published online Dec 7, 2008. doi: 10.3748/wjg.14.7009
Published online Dec 7, 2008. doi: 10.3748/wjg.14.7009
Methotrexate induced sprue-like syndrome
Marta Maia Boscá, Ramon Añón, Rosana Villagrasa, Nelly Balza, Cirilo Amorós, Adolfo Benages, Gastroenterology Department, Hospital Clínic Universitari of València, Spain
Empar Mayordomo, Department of Anathomo-Pathology, Hospital Clínic Universitari of València, Spain
Juan Ramon Corts, Rheumatology Department, Hospital Clínic Universitari of València, Spain
Author contributions: Benages A supervised the article, Añón R, Bosca MM and Corts JR visited the patient, Mayordomo E reviewed the anathomopathology, Villagrasa R and Balza N reviewed the patients’ story and researched the published papers for similar cases, and Amorós C and Boscá MM wrote the case report.
Correspondence to: Marta Maia Boscá, Gastroenterology Department, Hospital Clínic Universitari of València, Universitat de València Avda. Blasco Ibanez 17 46010 Valencia, Spain. maiabosca@yahoo.es
Telephone: +34-96-3862600-51255 Fax: +34-96-3864767
Received: February 3, 2008
Revised: November 7, 2008
Accepted: November 14, 2008
Published online: December 7, 2008
Revised: November 7, 2008
Accepted: November 14, 2008
Published online: December 7, 2008
Abstract
A 52 year-old male patient diagnosed of ankylosing spondylitis presented with an iron deficiency anemia after a ten-month treatment of methotrexate. He did not respond to treatment with oral iron not a proton pump inhibitor and an upper endoscopy was performed. The histological study of the duodenal biopsies showed villus atrophy. After removing the methotrexate, administrating intramuscular iron and undertaking a gluten-free diet, the histological and analytical alterations progressively resolved.
Keywords: Methotrexate, Villous atrophy, Iron deficiency anemia, Paucisymptomatic, Absence of celiac antibodies