Iatrogenically-related, fatal methotrexate intoxication: a series of four cases |
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| Authors: | Moisa A Fritz P Benz D Wehner H-D |
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| Affiliation: | 1. Institut für Gerichtliche Medizin der Universität Tübingen, Nägelestr. 5, 72074 Tübingen, Germany;2. Pathologisches Institut, Robert-Bosch-Krankenhaus Stuttgart, Germany;1. Institute for General Practice, University Hospital of the Ludwig-Maximilians-University Munich, Germany;2. GZIM, Society for Promotion of Vaccination Medicine mbH, Berlin, Germany;1. Creighton University School of Medicine—Phoenix Regional Campus, Phoenix, AZ (ABL, KPB, PMB);2. Department of Psychiatry, Creighton University School of Medicine, St. Joseph׳s Hospital and Medical Center, Phoenix, AZ (JPC);1. Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, China;2. Department of Dermatology, Daping Hospital, Third Military Medical University, Chongqing, China;3. Institute of Toxicology, Third Military Medical University, Chongqing, China;4. State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China |
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| Abstract: | Since the early eighties, the folic antagonist methotrexate (MTX) has been used in long-term treatment of rheumatoid arthritis. Because of the high toxic potential clinical and laboratory controls at regular intervals and patient education in order to avoid misadventure is of overriding importance. We present four cases of fatal MTX intoxication due to medical malpractice from the Tübingen Institute of Forensic Medicine autopsy material, which show the severe consequences of MTX overdose. It becomes evident that among non-rheumatologists there still is need for information about toxicity and dose limitation in MTX low-dose treatment. |
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