Anaphylactoid reaction to high-dose methotrexate and successful desensitization.
Anaphylactic/anaphylactoid reaction to methotrexate (MTX) is uncommon. It may occur with the first dose (non-allergic reactions) or after a previous exposure to the drug (allergic or specific reactions). Desensitization has been shown effective in children with allergic-type reactions permitting the continuation of high-dose methotrexate (HDMTX) therapy. We report the case of a child with localized osteosarcoma who developed an anaphylactoid reaction after a first HDMTX course. A desensitization protocol was successfully applied allowing the administration of four additional courses. In our experience, desensitization can be a safe and effective procedure in children with anaphylactoid reactions to HDMTX.
Oulego-Erroz
Ignacio
I
Division of Pediatric Hematology and Oncology, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ignacio.oulego@gmail.com
Maneiro-Freire
Mercedes
M
Bouzón-Alejandro
Marta
M
Vázquez-Donsión
Manuel
M
Couselo
José Miguel
JM
D000707:Anaphylaxis / Q000209:etiology* / Q000517:prevention & control; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D012516:Osteosarcoma / Q000188:drug therapy; D013977:Tibia
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate