Accidental methotrexate overdose leading to multisystem toxicity: A case report.

Q1 Environmental Science Toxicology Reports Pub Date : 2024-11-19 eCollection Date: 2024-12-01 DOI:10.1016/j.toxrep.2024.101821

Md Asaduzzaman, Md Rezaul Karim, Prionti Saha, Md Majharul Islam, Sadia Satara Zaman, Soumitra Roy, Ranjon Kumer Roy, M M Jahangir Alam

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Abstract

Background: Methotrexate (MTX) is an extensively used chemotherapeutic agent with well-characterized toxicity profiles. This case report describes the clinical presentation, management, and outcome of a patient presenting with severe MTX toxicity.

Case presentation: A 35-year-old Bangladeshi female was admitted on March 9, 2024, with severe mucosal ulcerations, painful skin lesions, and gastrointestinal bleeding after ingesting Methotrexate daily for 12 days by mistake instead of the medication prescribed to her. On physical examination, there was severe injury involving skin and mucosa. The laboratory results showed severe pancytopenia and liver and kidney function in derangement. There was gradual improvement with the prompt withdrawal of Methotrexate, Folinic Acid therapy, and supportive therapies; most of the laboratory values returned to normal by day 14.

Conclusion: This case was one of severe Methotrexate poisoning, leading to profound systemic toxicity. Thus, timely recognition, immediate drug withdrawal, and aggressive supportive care comprising Folinic Acid therapy and hydration played a major role in this patient's management.

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甲氨蝶呤意外过量导致多系统毒性：1例报告。

背景：甲氨蝶呤（MTX）是一种广泛使用的化疗药物，具有良好的毒性特征。本病例报告描述了一位出现严重MTX毒性的患者的临床表现、处理和结果。病例介绍：一名35岁的孟加拉国女性于2024年3月9日入院，因每日误服甲氨蝶呤12天，出现严重粘膜溃疡、皮肤病变疼痛和胃肠道出血。体格检查发现严重的皮肤和粘膜损伤。实验室结果显示严重的全血细胞减少症和肝肾功能紊乱。随着甲氨蝶呤、亚叶酸治疗和支持治疗的迅速退出，病情逐渐好转；大多数实验室值在第14天恢复正常。结论：该病例为甲氨蝶呤严重中毒，引起全身严重毒性。因此，及时识别，立即停药，积极的支持治疗，包括叶酸治疗和水合作用在该患者的管理中发挥了重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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