Question

A 68-year-old woman with rheumatoid arthritis, well-controlled on methotrexate 15mg weekly and folic acid 5mg weekly (on a different day), presents for her routine blood monitoring. Which of the following results would necessitate immediate cessation of methotrexate and urgent rheumatology review?

Accepted Answer

White cell count 3.0 x 10^9/L (previously 5.5 x 10^9/L, normal 4-11)

Answer

Haemoglobin 110 g/L (previously 115 g/L)

Answer

ALT 70 U/L (previously 30 U/L, normal range <35 U/L)

Answer

Platelets 130 x 10^9/L (previously 180 x 10^9/L, normal 150-400)

Answer

Creatinine 100 µmol/L (previously 95 µmol/L, normal 60-120)

Practice question

A 68-year-old woman with rheumatoid arthritis, well-controlled on methotrexate 15mg weekly and folic acid 5mg weekly (on a different day), presents for her routine blood monitoring. Which of the following results would necessitate immediate cessation of methotrexate and urgent rheumatology review?