ACUTE METHOTREXATE POISONING - REPORT OF 16 CASES REPORTED TO PARIS POISON CONTROL CENTER AND REVIEW OF LITERATURE

16 cases of acute methotrexate (MTX) poisoning were reported to the Pa ris Poison Control Centre and 62 others were published between 1974 an d 1995. Until 1992, MTX was mainly prescribed for neoplastic diseases. Clinical features involve acute renal failure, pancytopenia, and cuta neous or mucous injury. These cases emphasise major risk factors respo nsible for misuse and overdosage. Since 1992, MTX has been increasingl y used in rheumatological or pulmonary diseases (rheumatoid arthritis, steroid-dependent asthma). Most of the overdosages were due to a medi cal misuse (in the dosage regimen or a misunderstanding of the prescri ption by nurse, pharmacist or patient). All patients had a bone marrow suppression. The treatment is based especially on early administratio n of folinic acid rescue.