Extremely high concentration of mexotrexate in blood serum leading to development of acute renal failure in a patient with acute lymphoblastic leukemia after high-dose consolidation

• Main Authors: Mariya Anatol'evna Pimenova, Andrey Nikolaevich Sokolov, Lyudmila Semenovna Biryukova, Elena Nikolaevna Ustinova, Inna Ivanovna Shaforostova, Irina Anatol'evna Donskova, Rashit Fargatovich Bogdanov, Elena Nikolaevna Parovichnikova, Valeriy Grigor'evich Savchenko, M A Pimenova, A N Sokolov, L S Biryukova, E N Ustinova, I I Shaforostova, I A Donskova, R F Bogdanov, E N Parovichnikova, V G Savchenko
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2011-07-01
• Series: Терапевтический архив
• Subjects: acute lymphoblastic leukemia; high dose methotrexate; acute renal failure; hemodiafiltration; homozygous mutation of methylene-tetrahydrofolate reductase gene
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/30890

Acute renal failure (ARF) is one of rare and severe methotrexate(MT)-induced complications in patients with acute lymphoblastic leukemia. A case of MT-induced renal dysfunction with an extremely high serum MT concentration is reported. This toxicity required conduction of hemodiafiltration for extracorporeal MT elimination. The presence of homozygous mutation of methylene-tetrahydrofolate reductase reflects an individual metabolism of MT and its renal clearance.