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[Desensitization protocol to methotrexate. Clinical case].

Jonathan Maya-Epelstein¹, Alexander Morales, Blanca Del-Rio-Navarro

¹Servicio de Alergia e InmunologÌa ClÌnica, Hospital Infantil de MÈxico Federico GÛmez, MÈxico D.F. jmaya01@yahoo.com.mx.

Revista Alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)

|September 7, 2013

Summary

This summary is machine-generated.

Anaphylaxis to methotrexate (MTX) can be safely managed. A 12-step desensitization protocol allowed a patient with methotrexate-induced anaphylaxis to receive life-saving treatment.

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Area of Science:

Immunology
Pharmacology
Oncology

Background:

Methotrexate (MTX) is a vital immunosuppressive and antineoplastic agent used for various conditions.
Immediate hypersensitivity reactions, including anaphylaxis, are rare but serious adverse effects of MTX.
A 17-year-old male with ALL L2 experienced anaphylaxis during MTX induction therapy.

Purpose of the Study:

To describe the successful desensitization of a patient with anaphylaxis to methotrexate.
To evaluate the safety and efficacy of a specific 12-step desensitization protocol for MTX hypersensitivity.

Main Methods:

Diagnostic skin testing was performed, which also elicited anaphylaxis.
A 5-day premedication regimen was followed by an 8-hour, 12-step intravenous infusion protocol, starting with a 1:1,000,000 dilution of MTX.
The patient received weekly IV MTX at 50mg/m2 for one year using the same protocol.

Main Results:

The patient was successfully desensitized to methotrexate.
The desensitization protocol was safe and effective, allowing for continued MTX therapy for one year.
Intensive care supervision was critical throughout the protocol.

Conclusions:

A 12-step MTX desensitization protocol is a safe and effective option for patients experiencing anaphylaxis.
This protocol enables the administration of essential MTX therapy in hypersensitive individuals.
Close medical supervision and adherence to safety precautions are paramount during desensitization.