Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Metotrexato/envenenamiento , Enfermedad Hepática Inducida por Sustancias y Drogas/diagnóstico , Psoriasis/complicaciones , Enfermedades de la Piel/diagnóstico , Cigoma/lesiones , Consumo de Bebidas Alcohólicas/efectos adversos , Antiinflamatorios no Esteroideos/efectos adversos , Metotrexato/efectos adversos , Metotrexato/sangre , Metotrexato/uso terapéutico , Interacciones Farmacológicas , Mucositis/patología , Insuficiencia Renal/complicaciones , Inhibidores de la Bomba de Protones/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/prevención & control , Enfermedad Hepática Inducida por Sustancias y Drogas/sangre , Disfunción Cognitiva , Ácido Fólico/administración & dosificación , Ácido Fólico/uso terapéutico , Levetiracetam/efectos adversos , Enfermedades Gastrointestinales/diagnóstico , Genitales Femeninos/lesiones , Enfermedades Hematológicas/diagnóstico , Antibacterianos/efectos adversosRESUMEN
Acute intoxication with methotrexate, used as an abortive, has not been described in Chile. We report two female patients, aged 15 and 24 years old, who presented with mucositis, erythrodermia, pancytopenia, and elevation of hepatic enzymes. Plasma methotrexate levels confirmed the clinical diagnosis and both patients were treated with high leucovorin doses and management of associated complications. In one patient, pregnancy continued, giving birth to a newborn with cranial, face and limb malformations. The second patient had a late rescue with leucovorin and was discharged with a persistent sensory motor neuropathy. Considering the severity of complications and that patients may deny its use, when there is reasonable clinical suspicion of methotrexate intoxication, leucovorin treatment should be started