증예(症例) : 류마티스 관절염 환자에서 Leflunomide와 Methotrexate의 병용 투여시 나타난 범혈구 감소증 1예 = Case Reports : A case of Pancytopenia due to combination treatment of Leflunomide and Methotrexate in patient with Rheumatoid Atrhritis

국문 초록 (Abstract)

DMARDs 단독투여에 반응하지 않는 류마티스 관절염 환자에서 Leflunomide와 MTX의 병용투여를 시도하게 되는 경우에 반드시 정기적인 혈액검사를 하고, 범형구 감소증 발생시 에는 약물 투여를 중단한 후 광범위 항생제, G-CSF를 사용하며, 병용투여 약물과 관련하여 folic acid 의 보충과 약물 배설을 유도하기 위해 charco1과 cholestyramine의 사용을 고려해야 할 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

The combination therapy of leflunomide and methotrexate(MTX) for whom have inadequate response to long-term therapy of other disease modifying antirheumatic drug is increased recently in rheumatoid arthritis (RA). There are few reports that pancytopenia is more frequently occurred when treated with combination of leflunomide and MTX compared to single therapy. Even if some case be reporedt that the incidence and mortality of pancytopenia is increased after combination therapy, there are not sufficient case report of that. We report a case of pancytopenia due to combination therapy of leflunomide and MTX for 8months, which is improved by using folic acid, cholestyramine and granulocyte colony stimulating factor(G-CSF).