Successful multiple-exchange peritoneal dialysis in a patient with severe hematological toxicity by methotrexate: case report and literature review [documento electrónico] / Arbey Aristizabal Álzate, ; John Fredy Nieto Ríos, ; Catalina Ocampo Kohn, ; Gustavo Adolfo Zuluaga Valencia,  . - 2019.
Obra : Brazilian Journal of Nephrology

Idioma : Inglés (eng)

Palabras clave :	Methotrexate  pancytopenia  renal insufficiency  peritoneal dialysis
Resumen :	Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. We reviewed 20 cases published to date of pancytopenia associated with methotrexate in patients on dialysis and found high morbidity and mortality, which is why its use in this type of patient is not recommended. However, when this complication occurs, a therapeutic option could be the use of multiple-exchange peritoneal dialysis in addition to supportive therapy for drug-related toxicity, although it is recognized that studies are required to show the role of multiple-exchange peritoneal dialysis in the removal of this medication.
Mención de responsabilidad :	Arbey Aristizabal-Alzate, John Fredy Nieto-Rios, Catalina Ocampo-Kohn, Lina Maria Serna-Higuita, Diana Carolina Bello-Marquez, Gustavo Adolfo Zuluaga-Valencia
Referencia :	J Bras Nefrol. 2018 Sep 21. pii: S0101-28002018005003402.
DOI (Digital Object Identifier) :	10.1590/2175-8239-JBN-2018-0095
PMID :	30281061
Derechos de uso :	CC BY
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