Twelve patients with rheumatoid arthritis treated for at least 12 months with methotrexate and 11 matched rheumatoid arthritis controls underwent a standard d-xylose absorption test. No patients had any pre-existing clinical of biochemical evidence of malabsorption. No significant difference was observed in the 1 hour plasma d-xylose estimation between methotrexate treated patients and controls. The 2 to 5 hour urinary excretion ratio, however, was significantly lower in the methotrexate-treated group compared with controls indicating a minor degree of malabsorption. Six of the methotrexate treated patients and 5 of the controls underwent endoscopic duodenal biopsy but neither group demonstrated any significant histological changes. In conclusion, methotrexate therapy in patients with rheumatoid arthritis produces mild intestinal malabsorption.
We describe two patients with rheumatoid arthritis treated with methotrexate (MTX) who developed Peyronie's disease during the course of their treatment. In one of the patients the penile fibrosis resolved on stopping the drug. The other patient's penile fibrosis partially resolved on stopping the drug. We suggest that Peyronie's disease can be a side-effect of MTX in the treatment of rheumatoid arthritis.
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