Ulcerative stomatitis as clinical clue to inadvertent methotrexate overdose

Gastrointestinal side effects and the developpement of toxic liver fibrosis a re well-known side effects of low dose methotrexate therapy. A female pa tient receiving a long term low dose methotrexate therapy for a seronegativ e chronic polyarthritis developed an ulcerative somatitis, as clinical clue to an inadvertently given methotrexate overdose. A summary of other side e ffects of methotrexate and of oral side effects of other cytostatic agents and immonosuppressive drugs is given.