Immune flare up or something else

Patient

Q: I am a 15 year old male on the medication of methotrexate. I have been on this medication for over a year. I do not know if this is a random flare up or another illness please message back as my parents are out of town and i have no phone.

Symptoms:  Excessive feces, low fever 100.5, back pain, swelling of feet and calfs
Doctor

A:   Hello,

Thanks for choosing "Ask the Doctor" for posting your query.

Methotrexate is an immunosuppressant which may exhibit the adverse effects like diarrhoea, fever and back pain as in your case. It may also affect kidney functions and cause swelling of feet. You can consult your physician to get kidney function tests done in order to diagnose methotrexate associated side effects. In that case you should also take an opinion regarding replacing methotrexate with other medications such as etanercept, anakinra or monoclonal antibodies like adalimumab, rituximab, and infliximab. Changing a medicine would be recommendable.
Hope I am able to answer your concerns.
Wish you good health!

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