Methotrexate poisoning with acute hepatorenal dysfunction

Journal of Toxicology. Clinical Toxicology
E GotoK Tanaka

Abstract

A 17-year-old girl receiving high-dose methotrexate for the treatment of osteosarcoma developed complications of acute renal failure and liver dysfunction with a coagulation disorder. The methotrexate concentrations were quickly reduced from 600 micromol/L to 50 micromol/L by treatment with plasma exchange and hemodialysis at 72 hours after discontinuation of the drug. After this reduction, continuous hemodiafiltration was initiated to further lower the methotrexate concentrations because of the persistently high and then the actual rebound in the plasma concentrations after plasma exchange and hemodialysis treatment. Continuous hemodiafiltration was able to reduce the concentrations without any rebound, despite its low column clearance. The rebound in plasma methotrexate concentrations seems to be corrected by plasma methotrexate after plasma exchange and/or hemodialysis.

References

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Jun 28, 1986·Lancet·E BouffetM Brunat-Mentigny

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Citations

Jul 27, 2011·Environmental Toxicology and Pharmacology·Sally S AlamAbeer H Abd El-Rahim
Sep 25, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Lorenz SellinStefan M Weiner
Oct 22, 2003·Journal of Clinical Apheresis·Naci TiftikUgur Oral
Jun 9, 2006·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·O M Escobosa SánchezT Acha García
Apr 9, 2018·Rheumatology International·Biljana Radovanović-DinićSaša Grgov
May 14, 2005·Toxicology and Applied Pharmacology·Mustafa CetinerBerrak C Yeğen

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