Severe nephrotoxicity during high-dose methotrexate administration in an adolescent with acute lymphoblastic leukemia

Arch Argent Pediatr. 2024 Dec 5:e202410510. doi: 10.5546/aap.2024-10510.eng. Online ahead of print.
[Article in English, Spanish]

Abstract

High-dose methotrexate is an effective and safe therapy. It is included in the treatment regimens of various hematologic and oncologic diseases. The acute and severe toxicity of this chemotherapeutic agent is unusual. Nephrotoxicity occurs in about 2-12% of patients, associated with a slow clearance of the drug. It is usually reversible but requires an early approach. The objective was to describe the case of a patient diagnosed with lymphoblastic leukemia who presented with acute kidney injury after the administration of high doses of methotrexate.

Las altas dosis de metotrexato son una terapia eficaz y segura. Forma parte de los esquemas de tratamiento de diversas enfermedades hematológicas y oncológicas. La toxicidad aguda y grave de este agente quimioterápico es inusual. La nefrotoxicidad ocurre en alrededor del 2-12 % de los pacientes, asociado a un clearence lento de la droga. Suele ser reversible, pero requiere un abordaje precoz. El objetivo del presente trabajo es describir el caso de una paciente con diagnóstico de leucemia linfoblástica aguda que presentó una lesión renal aguda luego de la administración de altas dosis de metotrexato.

Keywords: acute kidney injury; drug-related side effects and adverse reactions; leukemia; methotrexate.

Publication types

  • Case Reports