低剂量甲索特雷克萨特毒性呈现与内病变和泛:一个案例报告
Kathleen A Clark1, Ashleigh Wilkerson2, Mike Zickella1
1Medical School, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus
|February 9, 2026
概括
甲托雷克萨特 (MTX) 毒性会导致严重的多系统问题,即使是低剂量. 早期识别胃肠道,和血清变化对于及时干预和预防不可逆转的损害至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 毒理学 毒理学 毒理学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 甲基 (MTX) 是一种疾病修饰性抗风湿药物 (DMARD),有效治疗类风湿性关节炎.
- MTX具有狭窄的安全边际,并通过脏清除,增加功能障碍或并发症患者的毒性风险.
- 剂量错误也可能导致严重的MTX毒性.
研究的目的:
- 报告一个罕见的病例,严重的多系统毒性从低剂量甲状腺素在一个病人多个并发症.
- 强调早期识别粘膜皮肤和胃肠道症状以及MTX毒性中细胞衰竭的重要性.
- 强调需要进行警的监测,即使是低剂量抗风湿性药物.
主要方法:
- 一个74岁的男性患有类风湿性关节炎和多种并发症的病例报告.
- 详细的临床表现包括渐进的虚弱,口腔/生殖器,腹,胰岛素减肥,急性损伤和高氨基酶.
- 治疗包括停止MTX和支持性护理.
主要成果:
- 尽管患者每周接受低剂量MTX,但患者出现了严重的粘膜皮肤毒性,胰岛素减肥,急性损伤和透氨炎.
- 症状包括疼痛的口腔和生殖器,水性腹,以及从沟中出血.
- 实验室发现证实了细胞衰竭,肌炎和功能障碍,这些症状在支持性治疗后得到改善.
结论:
- 低剂量MTX的危及生命的毒性并不常见,但可能发生,特别是在患有功能障碍等危险因素的患者中.
- 早期发现胃肠道症状,和细胞衰竭对于管理MTX毒性至关重要.
- 及时识别和干预至关重要,因为晚期毒性可能不会响应leucovorin救援.
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