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2017, Number 6

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Rev Mex Pediatr 2017; 84 (6)

Delayed removal of methotrexate in a patient with acute lymphoblastic leukemia

Zamarripa-Martínez KS, Mejía-Alba JÁ

Language: Spanish
References: 10
Page: 245-247
PDF size: 165.50 Kb.


ABSTRACT

The delay in the elimination of methotrexate (MTX) with acute renal failure is considered a medical emergency for which various therapeutic measures have been proposed, focused mainly on the rapid elimination of the drug. The reports in the literature are scarce. We present the case of a 13-year-old male patient with acute lymphoblastic leukemia who required the use of high doses of MTX (5 g/m2) as part of the consolidation treatment. During the first hours of administration, there was intense vomiting and impaired hydration status, which led to an increase in creatinine. At the same time, high levels of MTX (124 mmol/L) were found. Despite the increase in IV fluids and the rescue of folinic acid, no improvement was observed, so six hemodialysis sessions were carried-out. With this therapy, creatinine levels and MTX decreased progressively to normal values.


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