Methotrexate induced accelerated nodulosis (
MIAN) is a rare but unique side effect of
methotrexate therapy. There is paucity of data from our country about this entity. We analyzed 14 cases of
MIAN and studied its association with gender,
rheumatoid factor positivity and dose and duration of
methotrexate. Fourteen patients (8 females), 12 with
rheumatoid arthritis (8 seropositive), one each with juvenile idiopathic (JIA) and
psoriatic arthritis (PsA) were detected to have
MIAN during study period. All the patients presented with acute onset of multiple nodules. Radial border of fingers was the most commonly involved site. Disease was inactive in all but two patients at the time of appearance of
MIAN. There was no association of
MIAN with gender,
rheumatoid factor positivity, disease duration, cumulative dose and duration of
methotrexate therapy. Two patients each were treated with
colchicine,
D-penicillamine or hydroxy-
chloroquine for 3-6 months without any response. We conclude that
MIAN is a benign side effect of
methotrexate treatment.