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Methotrexate-induced posterior reversible encephalopathy syndrome.
MedLine Citation:
PMID:  21210832     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
What is known and Objective:  Posterior reversible encephalopathy syndrome (PRES) is described clinically as an acute neurologic deterioration characterized by headache, change in mental status and seizures. Although the mechanism(s) for this syndrome is not fully understood, PRES results from vasogenic edema in areas of the brain supplied by the posterior circulation. Methotrexate (MTX)-induced neurotoxicity is a well-known complication of therapy in the paediatric population but is uncommon in adults. Details of the Case:  We describe a 55-year-old woman with an acute presentation of PRES caused by intrathecal MTX given as part of a treatment regimen for diffuse large B-cell type lymphoma. Both clinical symptoms and radiographic abnormalities resolved 5 days after cessation of treatment. What is new and Conclusion:  We describe what we believe to be the first report of intrathecal MTX-induced PRES in an adult. Clinicians should include MTX-induced PRES in the differential diagnosis of acute neurologic changes in patients receiving this medication. The incidence of MTX-induced neurotoxicity may be under recognized in adults.
Authors:
E Aradillas; R Arora; J Gasperino
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-9-30
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  -     ISSN:  1365-2710     ISO Abbreviation:  -     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2011-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Neurology Section of Critical Care, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
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