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Case Reports
. 2024 Jul 8;16(7):e64081.
doi: 10.7759/cureus.64081. eCollection 2024 Jul.

A Case Report on Iatrogenic Methotrexate Toxicity

Kristina L Quan Soon  1 , Sundeep Shah  1 , Ramy Ibrahim  2 , Khalid Alzwahereh  3
Affiliations
Case Reports

A Case Report on Iatrogenic Methotrexate Toxicity

Kristina L Quan Soon et al. Cureus. .

Abstract

This case study studies the adverse effects of methotrexate toxicity as well as the importance of early recognition of the symptoms and signs of methotrexate toxicity. This study involves a 54-year-old female who accidentally took methotrexate in high doses for a period of five consecutively days. The patient had been diagnosed with mixed connective tissue disease and was being treated with methotrexate once weekly. However, she took 7.5 mg (three tablets) three times a day for five days instead of 15 mg once weekly in two divided doses. The patient immediately went to the ER but was asymptomatic and discharged after a CBC showed values within the normal range. The patient was then seen by her primary care physician and advised to return to the ER. At this time, the patient had mucocutaneous lesions and was complaining of oral and throat pain, and a repeat CBC demonstrated pancytopenia. The patient was admitted to the hospital for further management and treatment of methotrexate toxicity.

Keywords: immunosuppression; leucovorin; methotrexate; mucositis; rheumatoid; toxicity.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Computed tomography (CT) scan of the abdomen showing colonic inflammation
Colitis is indicated by spearhead arrows.
See this image and copyright information in PMC

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