methotrexate contributed to my fathers recent death - Arthritis Message Board

flapjabby · 10-17-2007, 11:46 PM

I've heard this is very, very rare but just wanted to post to maybe benefit someone else.

My father was put on methotrexate in Aug this year for *suspected* rheumatoid arthritis (2.5mg, 4 tablets/week). After only his second dose, he started having nose bleeds so he immediately went to the ER per his Doctor's instructions. He was in the hospital for 2 weeks, receiving transfusions for low plateletts and low white blood count (WBC). His WBC continued to drop. He was put in isolation. The doctors tested for leukemia, lymphoma, and other blood disorders (parvovirus B16) ... all which came back negative. In addition to nose bleeds, he had some small amounts of blood on toilet paper but his Drs thought it was likely from hemorroids and said they'd focus on that after figuring out what was wrong with his bone marrow. His Drs talked about bone marrow replacement in the future and sent him home. 2-3 days after being home he was back at the ER with severe stomach pain and was put in ICU. He had developed an infection in his bowels that progressed to the point where gangrene had set in and part of his bowels had perforated, letting air into his body cavity. Sepsis rapidly set in. Drs did a highly risky (due to low platelette and WBC) emergency surgery to remove the gangrene portions of his bowels. His body was in such bad shape from the sepsis, and his WBC and platelette count never recovered sufficient to allow his body to heal, that eventually, after a little more than a week from the re-admittance to ICU, he passed away.

All of this happened over about a 3.5 week period from first admittance to the hospital for nose bleeds after taking methotrexate, going from a healthy man in his mid-60s, to a tragic, unexpected end.

Posting this here as a start, hoping it may lead to better pre-screening for methotrexate prescriptions to avoid issues for at-risk patients. Something else may have been going on in my father that was missed by his Doctors, but the methotrexate seemed to be, and suspected by his Doctors, to be the unfortunate catalyst to this tragic end.

kellyswoman01 · 10-18-2007, 06:59 AM

Thank you for posting such a tragedy. I am sorry for the loss of your father. I looked up the side affects of the medicine your father was on and they are indeed scarey. It's sad but we do rely on our doctors to know what is best for us, but I think the doctor should take more time to go over the side affects with their patients and then give the patient the chance to decide if they want the doctor to prescribe that medicine. It seems his doctor may have advised him of some of the side affects as he did instruct him to go to the er. Unless it was in the case that he called the doctor's office when this happened and was then instructed to go to the er. Regardless, it is sad that your father had to go through such pain trying to relieve his pain. Had your father only taken 2 doses or did they continue him on the medicine in the hospital? Sometimes unless we ask what the medicine is for that they give us when we are in the hospital, we have no idea what new medicines, if any, we are getting and the side affects of those. Again, I am sorry for the loss of your father.

Ronnied · 10-18-2007, 09:52 AM

I felt very sad reading your post about your father. I am very sorry for your loss. I was diagnosed with arthritis 4 years ago and the first medication I got was methotrexate. The first thing that happened to me was my hair fell out which was devastating. Then over a period of 6 months my liver count went from 24 to a whopping 150 and I was hospitalised for 4 days I also had a blood clot in my lung which meant medication to thin my blood. I was released from hospital and all methotrexate was stopped. Luckily for me, after a few weeks my liver went back to normal, but I can assure you I felt very poorly all the time I was on it. My hair came back, only to fall out again with the next dmard they gave me (but thats another story). Some people seem to tolerate methotrexate others dont. I hope you feel stronger soon, and once again sorry about your father.

huckfinn · 10-18-2007, 12:49 PM

I am very sorry to hear of the loss of your father. G-d bless you.

I read the possible side effects about 2 years ago, and wondered how people could take the medicine, and more importantly how could a doctor prescribe it. I posted these possible side effects on a forum and was lamblasted.....

louie112 · 10-18-2007, 04:55 PM

just so everyone knows a liver count is not serious until it is well beyond 500. Hospitilization before that is usually for some other reason.

Methotrexate does have serious side effects. the decision to take it is not an easy one. For me to sit in a chair at 54 every day was as good as dying. My hair did fall out. I switched to enbrel which is far worse than methotrexate in terms of side effects. if I have 1 day without pain I will be happy when i die. for someone else this may not be their decision. My children know I am on these m eds and I have told them they need to spend time with me now because there may not be a tomorrow. It is my decision. I can move, dance take walks even type now, prior to the meds I could do nothing. Methotrexate shouyld never be the first drug someone is given. a good dr will start with nasaids at high doses only if they fail should a dr. try methotrexate and enbrel.