Dose of Methotrexate the Association with Methotrexate Induced Rheumatoid Nodulosis

To the editor Methotrexate induced rheumatoid nodulosis (MIRN) is rarely seen side effect associated with treatment of methotrexate. This side effect tends to multiply and mostly develops at the extremity of distal parts. Immunopathogenetic mechanisms are the most blamed factor pathogenesis of MIRN [1]. However pathogenesis is the unclear and very complex. We present a case when the dose of methotrexate was changed, MIRN was developed or overlooked.