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A 50-year-old woman with rheumatoid arthritis, managed with Methotrexate 15mg weekly and Folic Acid 5mg weekly (on a different day), presents with painful oral ulcers and nausea persisting for 3 days. Blood tests reveal: Hb 110 g/L, WBC 2.5 x10$^9$/L, Neutrophils 0.8 x10$^9$/L, Platelets 95 x10$^9$/L. What is the most likely cause of these findings?

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