Methotrexate-Induced Mucositis: A Consequence of Medication Error in a Rheumatoid Arthritis Patient

Cureus. 2023 Sep 30;15(9):e46290. doi: 10.7759/cureus.46290. eCollection 2023 Sep.

Abstract

Methotrexate (MTX) is a commonly prescribed medication for the treatment of rheumatoid arthritis (RA). Although effective in managing rheumatoid arthritis symptoms, methotrexate can have adverse effects, including mucositis. This study highlights a case of methotrexate-induced mucositis resulting from a medication error in a patient with rheumatoid arthritis. The 69-year-old patient recently diagnosed with rheumatoid arthritis was receiving methotrexate therapy as a part of his treatment plan. The patient, however, unintentionally ingested an excessive dose of methotrexate because of a communication error that occurred during the medication administration process. He started displaying signs of oral mucositis, characterized by uncomfortable ulcers and oral mucosa inflammation, within a short period. The buccal mucosa, tongue, and gingiva of the patient's oral cavity displayed numerous ulcerative lesions upon examination. Due to the mucositis's severity, it was challenging to eat, speak, and perform regular oral hygiene procedures. The patient described severe discomfort that had a detrimental effect on his general quality of life. This case serves as a reminder of the importance of accurate medication administration and communication in the management of rheumatoid arthritis. Healthcare professionals should ensure proper dosing and monitoring to minimize the risk of medication errors and associated complications. Additionally, patients should be educated about the potential side effects of methotrexate, including mucositis, to enable early recognition and timely intervention. In conclusion, this study emphasizes the occurrence of methotrexate-induced mucositis because of medication administration errors in a patient with rheumatoid arthritis. By increasing awareness of this potential complication, healthcare providers can improve patient safety and enhance the overall management of rheumatoid arthritis treatment.

Keywords: folinic acid; medication error; methotrexate; mucositis; rheumatoid arthritis.

Publication types

  • Case Reports