Iatrogenic methotrexate overdose: a case series. Risks in the practice of a family doctor

Author:

Smędra Anna1ORCID,Berent Jarosław1ORCID,Wochna Katarzyna1ORCID

Affiliation:

1. Chair and Department of Forensic Medicine, Medical University of Lodz, Łódź, Poland

Abstract

Intoxication with methotrexate has been occasionally reported during the treatment of autoimmune diseases, and remains a significant problem. Intoxications are caused by incorrect prescriptions issued by physicians or misadventure. An overdose usually leads to the death of the patient, as it is usually apparent only after the symptoms of bone marrow aplasia develop. At this stage, only symptomatic treatment, which is known to have low efficacy, can be administered. Methotrexate overdose remains within the scope of interest of family doctors, perhaps not as prescribing physicians, but as medical professionals extending prescriptions for chronically taken medications ordered by specialists, mainly rheumatologists or dermatologists. In this paper, we describe a series of cases of methotrexate intoxication occurring in very different circumstances. In these cases, we were approached as experts to issue an opinion on the correctness of the medical procedure. Such cases should be consistently reported to enhance awareness not only within healthcare systems but also in society at large.

Publisher

Medical Communications Sp. z.o.o.

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