NUMERO: #20240720

Título: CHRONIC ORAL ULCERATION AS AN INDICATOR OF ANEMIA INDUCED BY LOW-DOSE METHOTREXATE: A CASE REPORT

Nome do Apresentador: Matheus de ABREU

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Estomatologia

Resumo: A 72-year-old woman with rheumatoid arthritis managed with low-dose methotrexate sought the Oral Diagnosis Center complaining of multiple shallow and painful oral ulcerations persisting for three months. Previously diagnosed as inflammatory/immunomediated lesion, she had been unsuccessfully treated with topical steroids and low-level laser. The differential diagnosis included ulcerated lesions of infectious origin or adverse drug reaction, and an incisional biopsy was performed. Histopathological analysis revealed nonspecific findings, characterized by chronic and acute inflammatory processes and ulceration. Two days post-biopsy, the patients condition deteriorated significantly, prompting hospital admission. A notable reduction in blood cell count was observed, leading to methotrexate discontinuation and blood transfusion, resulting in a rapid improvement in her overall health status and resolution of the oral ulcerations within one week. Prolonged use of immunosuppressive drugs in elderly women with rheumatoid arthritis may cause oral ulcers due to opportunistic infections or adverse reactions, necessitating accurate diagnosis for effective management.

Autor 1:  Matheus de ABREU

E-mail 1:  [email protected]

Autor 2:   Gabriela Banacu de Melo

E-mail 2:  [email protected]

Autor 3 :  Maria Emília Mota Galdino Ferreira

E-mail 3:  [email protected]

Autor 4:  Samanta Vicente de Oliveira

E-mail 4:  [email protected]

Autor 5:  Daniele Heguedusch

E-mail 5:  [email protected]

Autor 6:  Marília Trierveiler

E-mail 6:  [email protected]

Autor 7:  Camila de Barros Gallo

E-mail 7:  [email protected]