Gauthier E, Gimonet J F, Piedbois P, Rostoker G, Buisson C, Ben Maadi A, Samyn B, Messadi A A, Brun B, Feuilhade F
Département de Cancérologie, CHU Henri-Mondor, Créteil.
Presse Med. 1990;19(44):2023-5.
In a case of acute intoxication with high-dose methotrexate, a kinetic study of plasma methotrexate concentrations enabled the authors to begin treatment with high-permeability membrane haemodialysis combined with intensive folic acid loading before the clinical signs of iatrogenic toxicities developed, and to continue with haemodialysis rather than using other depurative methods. In this case, the post-depuration course was favourable: dermatological signs and febrile pancytopenia regressed within 4 days, and these was no sign of hepatic toxicity.
在一例高剂量甲氨蝶呤急性中毒病例中,通过对血浆甲氨蝶呤浓度进行动力学研究,作者得以在医源性毒性的临床症状出现之前,就开始采用高通量膜血液透析联合大剂量叶酸负荷治疗,并持续进行血液透析而非使用其他净化方法。在该病例中,净化后的病程较为顺利:皮肤症状和发热性全血细胞减少在4天内消退,且无肝毒性迹象。