title: [Acute poisoning with methotrexate used as an abortifacient: description of 2 cases].
abstract: Acute intoxication with methotrexate, used as an abortive, has not been described in Chile. We report two female patients, aged 15 and 24 years old, who presented with mucositis, erythrodermia, pancytopenia, and elevation of hepatic enzymes. Plasma methotrexate levels confirmed the clinical diagnosis and both patients were treated with high leucovorin doses and management of associated complications. In one patient, pregnancy continued, giving birth to a newborn with cranial, face and limb malformations. The second patient had a late rescue with leucovorin and was discharged with a persistent sensory motor neuropathy. Considering the severity of complications and that patients may deny its use, when there is reasonable clinical suspicion of methotrexate intoxication, leucovorin treatment should be started.
authors.affiliation: Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile. jalfaro@ns.hospital.uchile.cl
authors.forename: J
authors.initials: J
authors.lastname: Alfaro
authors.forename: R
authors.initials: R
authors.lastname: Von Mühlenbrock
authors.forename: N
authors.initials: N
authors.lastname: Burgos
authors.forename: E
authors.initials: E
authors.lastname: Valdés
authors.forename: C
authors.initials: C
authors.lastname: Gana
authors.forename: G
authors.initials: G
authors.lastname: Conte
authors.forename: D
authors.initials: D
authors.lastname: Araos
authors.forename: L
authors.initials: L
authors.lastname: Plate
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000506:poisoning*; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D002955:Leucovorin / Q000627:therapeutic use; D008727:Methotrexate / Q000506:poisoning*; D011247:Pregnancy
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000931:Antidotes; D002955:Leucovorin; D008727:Methotrexate