Lee A C, Wong K W, Fong K W, So K T
Department of Paediatrics, Tuen Mun Hospital, New Territories, Hong Kong.
Acta Paediatr. 1997 Apr;86(4):434-7. doi: 10.1111/j.1651-2227.1997.tb09039.x.
We report two cases of intrathecal methotrexate overdose. A 3-y-old girl with acute lymphoblastic leukaemia and a 4-y-old boy with Burkitt's lymphoma were to receive an intrathecal injection of methotrexate after completion of intravenous methotrexate infusion. Instead of 12.5 mg, they both received a dose of 125 mg. Both children developed generalized convulsion 3 h after the overdose, but afterwards recovered completely. Intravenous folinic acid and dexamethasone rescue were employed, but no attempt was made to exchange the cerebrospinal fluid. In addition to the staff's failure to check the drug label carefully, the marked resemblance of the two dose preparations of methotrexate (50 mg/5 ml and 500 mg/5 ml) may have been contributory.
我们报告了两例鞘内注射甲氨蝶呤过量的病例。一名3岁患急性淋巴细胞白血病的女孩和一名4岁患伯基特淋巴瘤的男孩在完成静脉注射甲氨蝶呤输注后，准备接受鞘内注射甲氨蝶呤。他们两人均未接受12.5毫克的剂量，而是都接受了125毫克的剂量。两名儿童在过量用药3小时后均出现全身性惊厥，但随后完全康复。采用了静脉注射亚叶酸和地塞米松进行抢救，但未尝试进行脑脊液置换。除了工作人员未仔细核对药物标签外，甲氨蝶呤两种剂型（50毫克/5毫升和500毫克/5毫升）外观极为相似可能也是一个原因。
