Acute respiratory distress syndrome following intrathecal methotrexate administration: a case report and review of literature

@article{Dai2000AcuteRD,
  title={Acute respiratory distress syndrome following intrathecal methotrexate administration: a case report and review of literature},
  author={Ming-shen Dai and C. L. Ho and Y. C. Chen and W. Y. Kao and Tsu Yi Chao},
  journal={Annals of Hematology},
  year={2000},
  volume={79},
  pages={696-699}
}
Abstract Acute Respiratory distress syndrome (ARDS) is a rare complication following intrathecal (IT) injection of methotrexate (MTX) in adult acute lymphoblastic leukemia (ALL) patients. A 19-year-old man with ALL developed strikingly acute respiratory failure during central nervous system (CNS) prophylaxis with IT MTX administration and cranial irradiation. Histopathologic study of the lungs revealed a pattern of diffuse alveolar damage with interstitial cellular infiltration. His symptoms… 
Pulmonary Dysfunction in Pediatric Oncology Patients
TLDR
Infectious causes, lung disease resulting from anti-neoplastic agents, and bone marrow transplant-related pulmonary dysfunction are emphasized.
Pneumopathies médicamenteuses en réanimation Drug-induced lung diseases in the intensive care unit
The diagnosis of drug-induced lung disease (DILD) is a diagnosis of exclusion based on chronological and semiological criteria (intrinsic accountability) as well as bibliographic criteria (extrinsic
Pegylated interferon and ribavirin-induced interstitial pneumonitis with ARDS.
A 49-year-old man with cirrhosis due to hepatitis C virus developed interstitial pneumonitis documented by surgical lung biopsy specimen evaluation after two weekly doses of pegylated
Management of uncommon chemotherapy-induced emergencies.
TLDR
This work reviews these uncommon chemotherapy-induced life-threatening emergencies, their pathogenesis and management, and recommendations for rechallenge with the offending chemotherapy.
Breathing difficulties in children subjected to bone marrow transplantation
TLDR
The different causes of respiratory distress after BMT in relation to its initiation or the presence of infection in its origin are described.
Impact of open lung biopsy for undiagnosed pulmonary infiltrates in patients with hematological malignancies
TLDR
Open lung biopsy in patients with hematological malignancy may be useful in selected patients with a treatable hematologic disease who have treatable underlying causes of the pulmonary infiltrate.
Acute pulmonary capillary leak syndrome during elective surgery under general anesthesia
TLDR
According to the “two-hit” hypothesis, the bacterial infection preceding the operation may have primed the immune cells, and the following surgical stress may have then triggered rapid progression of acute respiratory distress syndrome.
Breathing difficulties in children with cancer
TLDR
A review of the most prevalent forms of respiratory distress in children with cancer without bone marrow transplantation describes the symptoms, diagnosis and treatment.
[Diagnostic strategy for acute respiratory failure in patients with haematological malignancy].
TLDR
This review deals with acute respiratory failure in patients with haematological malignancy, includes a review of the recent literature and considers the current controversies, in particular the risk-benefit balance of fibreoptic bronchoscopy with BAL in severely hypoxaemic patients.
Intra-CSF administration of chemotherapy medications
TLDR
An updated examination on both well-established intra-CSF chemotherapies as well as agents having limited data, but reports of therapeutic benefit are provided.
...
1
2
3
...

References

SHOWING 1-10 OF 18 REFERENCES
Acute respiratory failure after intrathecal methotrexate administration.
TLDR
A case of acute respiratory failure following the administration of intrathecal methotrexate for prophylaxis of central nervous system leukemia (CNS) in a 3-year-old girl with acute lymphoblastic leukemia is reported.
Pulmonary disease complicating intermittent therapy with methotrexate.
TLDR
It is suggested but not proved that the pulmonary disease represented an adverse reaction to methotrexate therapy, and an allergic type granulomatous reaction was revealed on one patient.
Noncardiogenic pulmonary edema following injection of methotrexate into the cerebrospinal fluid
TLDR
Two cases of rapidly developing respiratory distress following the administration of methotrexate into the cerebrospinal fluid are reported, consistent with noncardiogenic pulmonary edema.
Methotrexate‐induced sudden fatal pulmonary reaction
TLDR
The authors suggest the patient was sensitized by the intrathecal methotrexate and then reacted with angioneurotic edema of the lung when given the first oral dose of methotreysate.
Methotrexate therapy and pulmonary disease.
Eight instances of a rapidly progressive pulmonary illness manifested by cough, dyspenea, fever, and cyanosis have been seen in patients on maintenance methotrexate therapy for leukemia. The
Adverse effects of intrathecal methotrexate in children with acute leukemia in remission.
A toxic syndrome characterized by fever, headache, and vomiting, lasting 2-5 days, occurred in 61% of 39 children with acute leukemia in complete remission, receiving central nervous system
Methotrexate pneumonitis induced by intrathecal methotrexate therapy. A case report with pharmacokinetic data
TLDR
A patient with adenocarcinoma of the breast metastatic to the leptomeninges was treated with 10 doses of intrathecal methotrexate (MTX) and autopsy findings were consistent with the pneumonitis that has been associated with intermittent oral, intramuscular, and intravenous MTX therapy.
Methotrexate pulmonary toxicity.
  • G. Cannon
  • Medicine
    Rheumatic diseases clinics of North America
  • 1997
TLDR
All patients receiving MTX should be educated concerning this potentially life-threatening drug toxicity and instructed to contact their physician immediately if significant pulmonary symptoms develop.
Paraplegia following intrathecal methotrexate. Report of a case and review of the literature
TLDR
The incidence of neurotoxicity may be reduced by employing lower doses of methotrexate in the presence of central nervous system leukemia, in older children and adults, and in the absence of epidural leakage.
Review: diagnosis of chemotherapy lung.
TLDR
The radiologist may be able to assess the probability of drug-induced lung disease by correlating radiographic and clinical data and information concerning concomitant or previous drug or radiation therapy.
...
1
2
...