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一例医源性甲氨蝶呤中毒的病例报告。

A Case Report on Iatrogenic Methotrexate Toxicity.

作者信息

Quan Soon Kristina L, Shah Sundeep, Ibrahim Ramy, Alzwahereh Khalid

机构信息

Internal Medicine, Premier Medical Associates, The Villages, USA.

Research, Premier Medical Associates, The Villages, USA.

出版信息

Cureus. 2024 Jul 8;16(7):e64081. doi: 10.7759/cureus.64081. eCollection 2024 Jul.

Abstract

This case study studies the adverse effects of methotrexate toxicity as well as the importance of early recognition of the symptoms and signs of methotrexate toxicity. This study involves a 54-year-old female who accidentally took methotrexate in high doses for a period of five consecutively days. The patient had been diagnosed with mixed connective tissue disease and was being treated with methotrexate once weekly. However, she took 7.5 mg (three tablets) three times a day for five days instead of 15 mg once weekly in two divided doses. The patient immediately went to the ER but was asymptomatic and discharged after a CBC showed values within the normal range. The patient was then seen by her primary care physician and advised to return to the ER. At this time, the patient had mucocutaneous lesions and was complaining of oral and throat pain, and a repeat CBC demonstrated pancytopenia. The patient was admitted to the hospital for further management and treatment of methotrexate toxicity.

摘要

本案例研究探讨了甲氨蝶呤毒性的不良反应以及早期识别甲氨蝶呤毒性症状和体征的重要性。该研究涉及一名54岁女性,她连续五天意外高剂量服用甲氨蝶呤。该患者被诊断为混合性结缔组织病,原本每周接受一次甲氨蝶呤治疗。然而,她连续五天每天三次服用7.5毫克(三片),而不是每周一次分两次服用15毫克。患者立即前往急诊室,但当时无症状,血常规检查显示各项指标在正常范围内后出院。随后患者的初级保健医生建议其返回急诊室。此时,患者出现了皮肤黏膜病变,并抱怨口腔和喉咙疼痛,复查血常规显示全血细胞减少。患者因甲氨蝶呤毒性被收治入院进行进一步治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fcb/11305145/fa71b9d38705/cureus-0016-00000064081-i01.jpg

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