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银屑病患者甲氨蝶呤急性中毒:病例报告。

Acute methotrexate toxicity in a patient with psoriasis: a case report.

机构信息

Medico-Legal Institute, Ibn Rochd University Hospital, Casablanca, Morocco.

University Hassan II, Faculty of Medicine and Pharmacy, Casablanca, Morocco.

出版信息

Pan Afr Med J. 2024 Jan 17;47:19. doi: 10.11604/pamj.2024.47.19.39012. eCollection 2024.

Abstract

Aside from rheumatoid arthritis, methotrexate is also used to treat cancer, psoriasis, and other diseases. Side effects with methotrexate are possible, as they are with any medication. This drug is extremely potent and has the potential to produce serious adverse effects. Those who use this medication need to be tracked often. We provide a case of a patient with psoriasis vulgaris who died due to methotrexate administration without proper dosage verification. A female patient in her forties had a history of psoriasis vulgaris of the lower limbs. Under treatment, she developed acute methotrexate toxicity. This drug was taken as an intramuscular injection per day in an infirmary without checking that the dose regimen prescribed was per week. She developed extensive bullous and pustular lesions associated with digestive signs related to generalized toxiderma. But at that point, she had septic shock, which led to her death a few weeks after the methotrexate injection. The medical responsibilities of the doctor, pharmacist, and nurse were discussed. To conclude, methotrexate is not a killer drug in most cases, but it can be extremely harmful if it's overused. Acute toxicity is a potentially fatal condition, and a deeper understanding of its potential toxicity is still necessary.

摘要

除类风湿关节炎外,甲氨蝶呤也用于治疗癌症、银屑病和其他疾病。与任何药物一样,甲氨蝶呤也可能出现副作用。这种药物非常有效,有可能产生严重的不良反应。使用这种药物的人需要经常进行跟踪。我们提供了一个病例,一名患有寻常型银屑病的患者因未进行适当剂量验证而死于甲氨蝶呤给药。一名四十多岁的女性患者下肢患有寻常型银屑病。在治疗过程中,她发生了急性甲氨蝶呤中毒。在医务室,她每天接受肌肉内注射该药物,而未检查所开的剂量方案是每周一次。她出现了广泛的水疱和脓疱性病变,伴有与全身性中毒性表皮坏死松解症相关的消化系统体征。但此时,她发生了感染性休克,这导致她在接受甲氨蝶呤注射后几周死亡。讨论了医生、药剂师和护士的医疗责任。总之,在大多数情况下,甲氨蝶呤并不是一种致命药物,但如果过度使用,它可能会非常有害。急性毒性是一种潜在的致命状况,仍需要更深入地了解其潜在毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a4/10957722/7aca79c0ccf1/PAMJ-47-19-g001.jpg

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