[A case of head and neck squamous cell carcinoma suffering from acute renal failure after methotrexate administrator]

A 56-year-old man was hospitalized for evaluation of left neck tumor. The biopsy of neck lymph node showed a squamous cell carcinoma. Since no primary lesion was detected, the diagnosis was primary unknown neck lymph node metastasis. The first course of our chemotherapeutic regimen consisted of CDDP, 5-FU, MTX and LV. After MTX infusion, the level of serum creatinine increased. Based on laboratory data, we diagnosed acute renal failure caused by MTX and added the infusion of Ringer and LV. The serum creatinine level decreased to the level before chemotherapy. In the second course, chemotherapy with only CDDP and 5-FU was administered, and the level of serum creatinine did not increase. In the present case, suitable intravenous drip infusion of Ringer's injection prevented irreversible renal dysfunction. Since the laboratory data did not show dysfunction of uriniferous tubule and renal glomerulus, we considered allergic nephritis as a possibility.