Anaphylaxis during the first course of high-dose methotrexate: a case report and literature review

作者：Pugi A; Benemei S; Vietri M; Tondo A; Calvani A M; Mugelli A; Vannacci A; Lapi F^*

来源：Journal of Clinical Pharmacy and Therapeutics, 2012, 37(2): 245-248.

DOI：10.1111/j.1365-2710.2011.01275.x

• adverse reaction
• anaphylaxis
• methotrexate
• pharmacovigilance

What is known and Objective: Methotrexate (MTX) is widely used in the management of paediatric cancer with a generally favourable benefit/risk profile. We report an unusual adverse drug reaction with the first course of high-dose MTX in a paediatric patient and review the literature for similar cases. %26lt;br%26gt;Case summary: An 11-year-old boy with small-cell osteoblastic osteosarcoma in the lower limb experienced a case of lifethreatening anaphylaxis during the first course of high-dose MTX. The adverse event occurred during the first course, likely due to an immune-mediated mechanism. We postulate that prior antineoplastic treatment might have contributed to the immune response to MTX. %26lt;br%26gt;What is new and Conclusion: Given that this reaction has rarely been reported, we discuss the present case with a review of other similar cases. Further studies are needed to substantiate this ` signal alarm%26apos; for serious MTX-related hypersensitivity reactions.

• 出版日期2012-4