Badurdeen Shiraz, Kang Sok-Leng, Saravanan Muniasamy
Department of Paediatrics, Basildon Hospital, Essex, UK.
BMJ Case Rep. 2011 Apr 26;2011:bcr1120103477. doi: 10.1136/bcr.11.2010.3477.
The authors present the youngest reported case of a single oral overdose of methotrexate in an otherwise well 19-month-old child who was treated with delayed folinic acid rescue. Initial history revealed possible ingestion of up to 10 tablets, each containing 2.5 mg of methotrexate. The peak methotrexate level was 0.67 µmol/l measured 8 h following ingestion. Depending on the protocol, methotrexate levels that remain greater than 0.05-0.1 µmol/l for 24-48 h are associated with risk of toxicity. No adverse sequelae were noted during hospital admission despite delayed folinic acid rescue and there was no evidence of myelosuppression for up to 3 weeks following the overdose.
作者报告了一例19个月大健康儿童单次口服过量甲氨蝶呤的最年轻病例，该患儿接受了延迟亚叶酸救援治疗。初始病史显示可能摄入了多达10片甲氨蝶呤，每片含2.5毫克。摄入后8小时测得甲氨蝶呤峰值水平为0.67微摩尔/升。根据治疗方案，甲氨蝶呤水平在24至48小时内持续高于0.05 - 0.1微摩尔/升与中毒风险相关。尽管进行了延迟亚叶酸救援，但住院期间未发现不良后遗症，且过量摄入后长达3周没有骨髓抑制的证据。
