title: Acute respiratory distress syndrome following intrathecal methotrexate administration: a case report and review of  literature.
abstract: Acute Respiratory distress syndrome (ARDS) is a rare complication following intrathecal (IT) injection of methotrexate (MTX) in adult acute lymphoblastic leukemia (ALL) patients. A 19-year-old man with ALL developed strikingly acute respiratory failure during central nervous system (CNS) prophylaxis with IT MTX administration and cranial irradiation. Histopathologic study of the lungs revealed a pattern of diffuse alveolar damage with interstitial cellular infiltration. His symptoms were relieved soon following treatment with corticosteroids and the pulmonary infiltrates resolved gradually. Pulmonary symptoms did not recur as he was continuously treated with oral corticosteroids.
authors.affiliation: Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: M S
authors.initials: MS
authors.lastname: Dai
authors.forename: C L
authors.initials: CL
authors.lastname: Ho
authors.forename: Y C
authors.initials: YC
authors.lastname: Chen
authors.forename: W Y
authors.initials: WY
authors.lastname: Kao
authors.forename: T Y
authors.initials: TY
authors.lastname: Chao
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*
chemical_list: D008727:Methotrexate