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Efectos cutáneos adversos agudos del metotrexato: un informe de caso que pone de relieve los retos terapéuticos
Saarthak Miglani1, Tanshi Daljit1, Anurita Srivastava1
1Oncology, Maulana Azad Medical College, India.
Toxicology reports
|August 21, 2025
Resumen
El metotrexato (MTX) puede causar toxicidad cutánea grave incluso en dosis bajas. El reconocimiento y el tratamiento tempranos son cruciales, especialmente en pacientes con factores de riesgo como el uso previo de antibióticos.
Área de la Ciencia:
- En el campo de la oncología
- Dermatología
- Farmacología
Sus antecedentes:
- El metotrexato (MTX) es un antimetabolito vital para el tratamiento de cánceres y enfermedades autoinmunes.
- Aunque generalmente es seguro en dosis bajas, MTX puede causar toxicidad significativa en individuos susceptibles.
Objetivo del estudio:
- Informar de un caso de toxicidad cutánea grave por dosis bajas de MTX por vía intravenosa.
- Para enfatizar la importancia de reconocer la toxicidad de MTX en pacientes con factores de riesgo específicos.
Principales métodos:
- Informe de caso de un hombre de 49 años con carcinoma de células escamosas avanzado de la mucosa bucal.
- Administración de una dosis baja de MTX por vía intravenosa (dos dosis semanales).
Principales resultados:
- El paciente desarrolló mucositis oral de grado 4 y múltiples placas eritematosas.
- La toxicidad se produjo a pesar del uso de dosis bajas de MTX por vía intravenosa.
Conclusiones:
- La toxicidad cutánea grave de MTX puede ocurrir incluso en dosis bajas.
- Los factores de riesgo como el uso previo de antibióticos y el bajo nivel de albúmina sérica pueden predisponer a los pacientes a la toxicidad por MTX.
- El reconocimiento y la gestión inmediatos son esenciales para mitigar los eventos adversos relacionados con MTX.
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