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
em En
| MEDLINE
| ID: mdl-33414115
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.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Metotrexato
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Linfoma de Burkitt
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Doença Hepática Induzida por Substâncias e Drogas
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Hiperbilirrubinemia
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Antimetabólitos Antineoplásicos
Tipo de estudo:
Prognostic_studies
Limite:
Child
/
Humans
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Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article