Intoxication Due to High Dose Methotrexate in a Patient with Rheumatoid Arthritis: A Case Report

Altindag, Ozlem; Küçükoğlu, Birsev

doi:10.5606/tjr.2011.009

Cited by 11 publications

(9 citation statements)

References 2 publications

(4 reference statements)

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“…Low-dose MTX is used to treat inflammatory diseases and high doses are used to treat malignancies 2 . However, high-dose MTX cause serious adverse effects 29 .…”

Section: Introductionmentioning

confidence: 99%

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

et al. 2016

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To investigate the effect of HRE (Hippophae rhamnoides extract) on oral mucositis induced in rats with MTX. Material and Methods: Experimental animals were divided into groups as healthy (HG), HRE+MTX (HMTX), and control group, which received MTX (MTXC). HMTX group received 50 mg/kg HRE while MTXC and HG groups received equivolume distilled water with gavage once a day. After one hour of HRE and distilled water administration, HMTX and MTXC groups received a single dose of oral MTX 5 mg/ TNFanimals receiving MTX, compared with HG and HMTX groups; however, these parameters were lower in the cheek and low lip tissue, and a milder damage ocurred in these tissues, compared with the tongue tissue in MTXC group. No histopathologic damage was observed in the cheek, lower lip, and tongue tissues of the rats treated with HRE. Conclusion: This synthetic drugs for prophylaxis of oral mucositis developed due to MTX.

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“…Low-dose MTX is used to treat inflammatory diseases and high doses are used to treat malignancies 2 . However, high-dose MTX cause serious adverse effects 29 .…”

Section: Introductionmentioning

confidence: 99%

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

et al. 2016

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“…Methotrexate (MTX) is a folic acid antagonist drug that inhibits dihydrofolate reductase and reduces the levels of tetrafolate in cells [1]. MTX has been widely used for nearly 20 years in the treatment of cancers (acute lymphoblastic leukemia, sarcoma, lung, breast, and bladder cancer) and inflammatory diseases (psoriasis, multiple sclerosis, and rheumatoid arthritis) because of its antiproliferative effect [2-4]. Whereas MTX is used in inflammatory diseases at 20 mg/m 2 weekly, it is applied in oncological diseases in high doses of 1,000 to 33,000 mg/m 2 [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of lutein on methotrexate-induced oxidative lung damage in rats: a biochemical and histopathological assessment

Mammadov

Akturan

Çimen

et al. 2019

Korean J Intern Med

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Background/AimsThis study aimed to investigate the effect of lutein on methotrexate (MTX)-induced pulmonary toxicity in rats biochemically and histopathologically.MethodsThe rats in the MTX + lutein (MTXL, n = 6) group were given 1 mg/kg of lutein orally. A 0.9% NaCl solution was administered orally to the MTX (n = 6) group and the healthy group (HG, n = 6). One hour later, a single 20 mg/kg dose of MTX was injected intraperitoneally in the MTXL and MTX. Lutein or 0.9% NaCl solution was administered once a day for 5 days. At the end of this period, malondialdehyde (MDA), myeloperoxidase (MPO), total glutathione (tGSH), interleukin 1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α) were measured in the lung tissues from the animals euthanized with 50 mg/kg thiopental sodium anesthesia. Subsequently, histopathological examinations were performed.ResultsThe levels of MDA, MPO, IL-1β, and TNF-α in the lung tissue of the MTX were significantly higher than those of the MTXL and HG groups (p < 0.0001), and the amount of tGSH was lower. The histopathological findings in the MTX group, in which the oxidants and cytokines were higher, were more severe.ConclusionsLutein prevented the MTX-induced oxidative lung damage biochemically and histopathologically. This result indicates that lutein may be useful in the treatment of MTX-induced lung damage.

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“…It is mostly used in neoplastic diseases and in the treatment of inflammatory diseases such as Rheumatoid arthritis (RA). Rarely, it can cause severe side effects such as agranulocytosis on the basis of bone marrow suppression, inflammation in mucosal tissues, hepatic necrosis, cirrhosis of the liver, pulmonary fibrosis and renal dysfunction [1]. We presented a case of newly diagnosed pancytopenia, stomatitis and gastrointestinal hemorrhage in a 69-year-old woman who had been mistakenly used intramuscular MTX every day.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal bleeding secondary to use of high-dose methotrexate: A case report

Peker¹,

Yarkıcı²,

Akar³

2018

Journal of Surgery and Medicine

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A 69-year-old female patient was admitted to our emergency service with painful oral ulcers and rectal bleeding. She has been used methotrexate (MTX) because of rheumatoid arthritis (RA). The patient has been used methotrexate every day for 10 days instead of a weekly treatment. Pancytopenia was seen in laboratory tests. Rectal bleeding associated with gastrointestinal mucosal erosion was attributed to MTX toxicity and MTX-induced thrombocytopenia. The direct cause of MTX intoxication in this case was accidental daily use instead of a weekly use. This case demonstrates the importance of communicating adequately with health professionals and emphasizes that MTX should be used weekly. It is essential to describe in detail how the medication can be used and what adverse effects may occur as the result of taking MTX.

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Intoxication Due to High Dose Methotrexate in a Patient with Rheumatoid Arthritis: A Case Report

Cited by 11 publications

References 2 publications

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

Effect of lutein on methotrexate-induced oxidative lung damage in rats: a biochemical and histopathological assessment

Gastrointestinal bleeding secondary to use of high-dose methotrexate: A case report

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