Treatment of Accidental Intrathecal Methotrexate Overdose With Intrathecal Carboxypeptidase G2

Accidental intrathecal methotrexate overdose.

Re: Treatment of accidental intrathecal methotrexate overdose.

Widemann et al. (1) presented data on the use of cerebrospinal fl uid (CSF) exchange to remove methotrexate before carboxypeptidase G 2 (CPDG 2) administration among patients who had an accidental intrathecal methotrexate overdose. They reported that CSF drainage removed 32% – 58% of the methotrexate dose. Although they showed the percent decreases in CSF methotrexate concentration before and a...

Brain damage after intrathecal methotrexate.

Ten brains from leukaemic patients given intrathecal methotrexate and 10 from leukaemic patients without intrathecal therapy have been examined. Three of the methodtrexate treated patients appear to have died from their therapy. The histological changes consisted of destruction of oligodendrocytes, sometimes complete over large areas, and sometimes relatively slight. All the patients who surviv...

Comparison of CNS Relapse, Survival and Intelligent Quotient in Non-High Risk ALL Children Treated with Intrathecal Methotrexate or Triple Intrathecal Therapy

Background Compared to intrathecal methotrexate (IT MTX), triple intrathecal therapy (TIT) has shown promising results in decr...

Accidental intrathecal administration of high dose diamorphine.

A case of accidental administration of high dose intrathecal diamorphine is reported in a patient who underwent total knee replacement. Initially a regional technique was planned for this patient, but due to inadvertent administration of three milligrams of diamorphine intrathecally, it was decided to convert the patient to have a general anaesthetic. Postoperatively, she was monitored in high ...