Miglani Saarthak, Daljit Tanshi, Srivastava Anurita, Rathi Arun Kumar
Oncology, Maulana Azad Medical College, India.
Toxicol Rep. 2025 Aug 9;15:102108. doi: 10.1016/j.toxrep.2025.102108. eCollection 2025 Dec.
Methotrexate (MTX) is a commonly used antimetabolite for managing various autoimmune disorders and cancers. While it is generally well-tolerated at low doses, certain factors may predispose patients to significant toxicity. Here we present a case of 49-year-old male with advanced buccal mucosa squamous cell carcinoma who developed acute severe cutaneous toxicity following low dose of intravenous MTX therapy. After receiving two weekly doses, the patient experienced grade 4 oral mucositis and multiple erythematous plaques. This case highlights the importance of early recognition and prompt management of MTX toxicity, even at low doses, particularly in patients with risk factors such as prior antibiotic use and low serum albumin levels.
甲氨蝶呤（MTX）是一种常用于治疗各种自身免疫性疾病和癌症的抗代谢药物。虽然低剂量时通常耐受性良好，但某些因素可能使患者易发生显著毒性。在此，我们报告一例49岁男性晚期颊黏膜鳞状细胞癌患者，在接受低剂量静脉注射MTX治疗后发生急性严重皮肤毒性。在接受两周一次的剂量后，患者出现4级口腔黏膜炎和多处红斑性斑块。该病例强调了即使是低剂量MTX毒性，早期识别和及时处理的重要性，尤其是在有危险因素（如既往使用抗生素和低血清白蛋白水平）的患者中。
