High-dose methotrexate-induced reversible grade 4 hyperbilirubinaemia and transaminitis in an adolescent with Burkitt Leukaemia.
BMJ Case Rep
; 14(1)2021 Jan 07.
Article
in English
| MEDLINE | ID: covidwho-1015617
ABSTRACT
Symptomatic drug-induced liver injury (DILI) is an uncommon problem. Direct DILI is dose-related, predictable with short latency (hour to days) and is generally associated with transient and reversible transaminitis without jaundice. Antimetabolites including methotrexate are a common cause for direct DILI. Hepatotoxicity associated with high-dose methotrexate (HD-MTX) is generally transient and includes reversible elevation of transaminase in up to 60% and associated hyperbilirubinaemia (≤grade 2) in 25% of courses and therefore is of no clinical significance. Severe grades of DILI with HD-MTX (grade ≥4) are extremely rare. We describe an adolescent with Burkitt leukaemia who had reversible grade 4 DILI including hyperbilirubinaemia postfirst course of HD-MTX. Rechallenge with two-third dose of HD-MTX in subsequent chemotherapeutic cycle did not cause recurrence of DILI.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Methotrexate
/
Burkitt Lymphoma
/
Chemical and Drug Induced Liver Injury
/
Hyperbilirubinemia
/
Antimetabolites, Antineoplastic
Type of study:
Case report
/
Prognostic study
Topics:
Vaccines
Limits:
Child
/
Humans
/
Male
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bcr-2020-237512
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