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Related Experiment Videos

Anaphylactoid reactions to methotrexate

S A Alkins1, J C Byrd, S K Morgan

  • 1Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. 20307-5001, USA.

Cancer
|May 15, 1996
PubMed
Summary
This summary is machine-generated.

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Immediate hypersensitivity reactions to methotrexate can occur upon initial exposure, challenging previous understanding. This highlights the need for vigilance and preparedness for anaphylactoid reactions even with the first dose.

Area of Science:

  • Oncology
  • Rheumatology
  • Pulmonology

Background:

  • Methotrexate is a widely used chemotherapeutic agent for various diseases.
  • Immediate hypersensitivity reactions are rare and typically occur after prior exposure.
  • Reported reactions include anaphylaxis, urticaria, and hepatitis.

Observation:

  • Two patients developed immediate systemic hypersensitivity reactions during initial methotrexate administration.
  • Patient 1 experienced anaphylactoid symptoms within 10 minutes of first dose.
  • Patient 2 developed urticaria and pruritus within 30 minutes of first dose.

Findings:

  • Anaphylactoid reactions to methotrexate can manifest during initial exposure.
  • Reactions occurred rapidly after intravenous administration of high-dose methotrexate.

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  • Symptoms included pruritus, urticaria, angioedema, and pharyngeal edema.

    • Implications:

    • Clinicians must consider the risk of immediate hypersensitivity reactions with the first dose of methotrexate.
    • Preparedness for treating potentially life-threatening reactions is crucial from the outset.
    • This finding contrasts with previous literature suggesting reactions only occur after prior exposure.