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Title: Anaphylaxis during the first course of high-dose methotrexate: a case report and literature review. Author: Pugi A, Benemei S, Vietri M, Tondo A, Calvani AM, Mugelli A, Vannacci A, Lapi F. Journal: J Clin Pharm Ther; 2012 Apr; 37(2):245-8. PubMed ID: 21569069. Abstract: WHAT IS KNOWN AND OBJECTIVE: Methotrexate (MTX) is widely used in the management of paediatric cancer with a generally favourable benefit/risk profile. We report an unusual adverse drug reaction with the first course of high-dose MTX in a paediatric patient and review the literature for similar cases. CASE SUMMARY: An 11-year-old boy with small-cell osteoblastic osteosarcoma in the lower limb experienced a case of life-threatening anaphylaxis during the first course of high-dose MTX. The adverse event occurred during the first course, likely due to an immune-mediated mechanism. We postulate that prior antineoplastic treatment might have contributed to the immune response to MTX. WHAT IS NEW AND CONCLUSION: Given that this reaction has rarely been reported, we discuss the present case with a review of other similar cases. Further studies are needed to substantiate this 'signal alarm' for serious MTX-related hypersensitivity reactions.[Abstract] [Full Text] [Related] [New Search]