分子吸附循环系统在甲氨蝶呤所致急性肝衰竭中的作用：一例报告及文献复习

Corbisier T, Von Bueren André O, Breunis W B, Grazioli S

Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Geneva, Switzerland.

Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Zurich, Switzerland.

Front Pediatr. 2024 Aug 15;12:1424919. doi: 10.3389/fped.2024.1424919. eCollection 2024.

We describe the case of a 14-year-old girl with osteosarcoma who was treated with high-dose methotrexate (12 g/m). Twenty-four hours after the infusion, her plasma methotrexate concentration was elevated at 937 μmol/L (normal < 10 µmol/L). She exhibited severe signs of methotrexate toxicity, including encephalopathy, acute liver failure (ALF), and acute kidney injury. In this case report, we highlight the severe and rare adverse effects secondary to methotrexate administration and the efficacity of molecular adsorbent recirculating system and continuous venovenous hemodiafiltration to recover from multiple organ failure.

我们描述了一名患有骨肉瘤的14岁女孩的病例，她接受了大剂量甲氨蝶呤（12 g/m）治疗。输注后24小时，她的血浆甲氨蝶呤浓度升高至937 μmol/L（正常<10 µmol/L）。她出现了甲氨蝶呤毒性的严重症状，包括脑病、急性肝衰竭（ALF）和急性肾损伤。在本病例报告中，我们强调了甲氨蝶呤给药继发的严重且罕见的不良反应，以及分子吸附再循环系统和持续静脉-静脉血液透析滤过从多器官功能衰竭中恢复的有效性。