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Myelopathy is a rare complication of methotrexate (MTX) therapy.1 A polymorphism (C677T) in the folate enzyme methylenetetrahydrofolate reductase (MTHFR) gene is associated with MTX hematologic and hepatic toxicity.2 We describe 3 cases of severe MTX myelopathy associated with the MTHFR C677T polymorphism.
Footnotes
Author contributions: Dr. Juster-Switlyk: drafting and editing the manuscript, composition of the tables and images. Dr. Smith: editing the manuscript. Dr. Kovacsovics: editing the manuscript. Dr. Stephens: editing the manuscript. Dr. Glenn: editing the manuscript. Dr. Palmer: pathologic diagnoses, editing the manuscript. Dr. Quigley: radiographic interpretation, editing the manuscript. Dr. Kolb: editing the manuscript.
Study funding: No targeted funding reported.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Received June 29, 2016.
- Accepted in final form October 25, 2016.
- © 2017 American Academy of Neurology
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