High-dose methotrexate-induced fulminant hepatic failure and pancytopenia in an acute lymphoblastic leukaemia paediatric patient
Autor: | Atmaram Pawar, Manjusha Sajith, Sandip Bartakke, Vibha Bafna |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Antimetabolites Antineoplastic Necrosis Pancytopenia Case Report 030226 pharmacology & pharmacy Gastroenterology Asymptomatic 03 medical and health sciences 0302 clinical medicine Fulminant hepatic failure Fatal Outcome Fibrosis Internal medicine medicine Humans 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics Adverse effect medicine.diagnostic_test Dose-Response Relationship Drug business.industry Liver Failure Acute Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Heart Arrest Methotrexate Child Preschool medicine.symptom Chemical and Drug Induced Liver Injury Liver function tests business medicine.drug |
Zdroj: | Eur J Hosp Pharm |
ISSN: | 2047-9956 |
Popis: | Methotrexate treatment has been associated with an array of liver-related adverse events like asymptomatic transaminase elevations, fatal necrosis and fibrosis. Here we present a child with relapse Pre B cell acute lymphoblastic leukaemia who developed and died of fulminant hepatic failure and pancytopenia soon after the administration of high-dose MTX. This case is unusual due to a series of adverse events that led to severe toxicity. The child received 1 g/m(2) dose of methotrexate infusion for 36 hours. The patient developed drowsiness with altered sensorium in the 72 hours after starting the infusion. Investigations revealed severe pancytopenia along with grossly deranged liver function tests and coagulation profile. On the fourth day of paediatric intensive care unit admission, the child went into cardiac arrest and could not be revived. |
Databáze: | OpenAIRE |
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