Accelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis

Rafael Segal*, Dan Caspi, Moshe Tishler, Beno Fishel, Michael Yaron

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Three women with classic rheumatoid arthritis, who were receiving weekly doses of methotrexate (MTX), developed accelerated subcutaneous nodulosis, despite good response to the drug. In 2 of the patients, the onset of nodulosis occurred within 3 months and 5 months, respectively, after starting MTX; in the third patient, it was observed only after 4 years of MTX therapy. In all 3 patients, the onset was unusually abrupt, with extensive distribution and remarkable nodule size. Additional manifestations of cutaneous vasculitis in 2 of the patients and Raynaud's phenomenon in the third appeared concomitantly with the nodulosis. Physicians prescribing MTX therapy for patients with rheumatoid arthritis should be aware of these potential complications.

Original languageEnglish
Pages (from-to)1182-1185
Number of pages4
JournalArthritis and Rheumatology
Issue number9
StatePublished - Sep 1988


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