NUMERO: #20250271

Título: ORAL TOXICITY ASSOCIATED WITH LOW-DOSE METHOTREXATE FOR RHEUMATOID ARTHRITIS: A CASE REPORT

Nome do Apresentador: Gabriela Banacu de Melo

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Estomatologia

Resumo: A 65-year-old female patient presented with symptomatic oral ulcers for about two months. With a history of recurrent aphthous stomatitis, she self-initiated topical treatment with triamcinolone acetonide, without improvement. Her medical history included osteoporosis and rheumatoid arthritis, for which she was using low-dose methotrexate (2,5mg/day). Intraoral examination revealed multiple superficial ulcerations with surrounding erythema on the buccal, alveolar mucosa and tongue borders, accompanied by white striations. The differential diagnosis included oral lichen planus and adverse reaction to methotrexate. An incisional biopsy of the buccal mucosa showed a dense mononuclear inflammatory infiltrate associated only with ulceration, supporting the hypothesis of methotrexate-induced oral toxicity. After consultation, the rheumatologist suspended the drug and prescribed folic acid. Complete remission of the lesions was observed after one week. Although low-dose methotrexate is widely used in rheumatoid arthritis due to its immunomodulatory effect, it may cause painful oral ulcers resistant to conventional treatments.

Autor 1:  Gabriela Banacu de Melo

E-mail 1:  [email protected]

Autor 2:   Nathalia Souza de Andrade

E-mail 2:  [email protected]

Autor 3 :  Bruno Munhoz Marotta

E-mail 3:  [email protected]

Autor 4:  Liliane Noaves Joaquim

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]