Toxidermie grave au méthotrexate

Toujani, S.; Abdelhafidh, N. Ben; Sayhi, S.; Bousetta, N.; Ajili, F.; Othmani, S.

doi:10.1016/j.revmed.2015.03.048

Cited by 1 publication

(11 citation statements)

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“…The patient was anemic on admission as was the case for most of the cases reported in the literature [ 3 , 5 , 8 ]. As in our case, pancytopenia seems constant during severe reactions to MTX [ 3 , 4 , 6 – 8 ]. Our patient presented with febrile neutropenia as in the cases reported by Shao et al.…”

Section: Discussionsupporting

confidence: 73%

“…[ 4 , 7 ]. The patient presented with fever, as with the majority of cases reported in the literature [ 3 , 4 , 6 – 8 ]. The patient presented with generalized phlyctenular maculopapular rashes associated with purpuric lesions and cutaneous jaundice.…”

Section: Discussionmentioning

confidence: 57%

“…This period is shorter than in the cases reported by Toujani et al. in Tunisia and that of Soysal in Turkey, which were both 6 days [ 5 , 6 ]. Note that this delay is longer than that reported by Gupta et al.…”

Section: Discussionmentioning

confidence: 58%

“…In the case reported by Toujani et al. , the patient presented with generalized erythema with no healthy skin interval associated with ecchymotic patches on the face and limbs [ 6 ]. The patient presented with erosion of the oral and pharyngeal mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…in Tunisia and by Lodha et al. in India [ 3 , 6 ]. These mucosal lesions appear to be of varying degrees, ranging from erythema of the oral mucosa to bleeding ulcers of the digestive tract [ 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Methotrexate-induced toxidermia and pancytopenia in a patient with ectopic pregnancy: a case report

et al. 2021

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Background Methotrexate is an anticancer drug from the antimetabolite class. It is also used in gynecology and obstetrics and is the molecule of choice for the medical treatment of ectopic pregnancies. We report a case of toxidermia associated with severe pancytopenia induced by methotrexate for ectopic pregnancy. Case presentation A 30-year-old Malagasy (African) woman was admitted to the Emergency and Intensive Care Department for probable toxidermia following injection of 75 mg of methotrexate for an ectopic pregnancy. She had developed generalized erythema, which started 48 hours after the injection. The secondary onset of phlyctenular maculopapular skin lesions, generalized purpura, and erosions of the oral mucosa in a context of febrile jaundice prompted her hospitalization. On admission, the patient presented with febrile neutropenia, pancytopenia, renal failure, and hepatic cytolysis. She received transfusions of fresh whole blood, erythromycin, and amphotericin B. The course was fatal within 2 days of hospitalization. The patient died of multiple organ failure. Conclusions Our case is mainly distinguished by the lack of use of granulocyte growth factors and folinic acid. In the event of severe reactions to methotrexate, the management should be multidisciplinary and as much as possible within an intensive care unit.

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