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.
Division of Pediatric Hematology and Oncology, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ignacio.oulego@gmail.com
Ignacio
I
Oulego-Erroz
Mercedes
M
Maneiro-Freire
Marta
M
Bouzón-Alejandro
Manuel
M
Vázquez-Donsión
José Miguel
JM
Couselo
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