| [ Summary ] |
Acute poisoning due to methotrexate (MTX) has been increasing recently. Although high dose MTX is used to treat malignancies, severe side effects, including bone marrow suppression, and lesions of the oral cavity and gastro-intestinal mucosa can occur. MTX poisoning becomes critical in many cases. Thus, in symptomatic cases who have MTX poisoning, MTX removal by acute blood purification must be performed even if poisoning symptoms are unclear. This is true even when it is accompanied by acute renal insufficiency or excessive administration of MTX. Our experience revealed direct hemoperfusion (DHP) to be more effective than other acute blood purification methods. However, MTX may rise again after a decrease in the MTX concentration with DHP. Attention must thus be paid to the blood MTX concentration during acute MTX poisoning. |