Successful therapeutic rechallenge after a severe episode of high dose methotrexate‑induced choreoathetosis: A case report

Chong,Lip  Leong; Wong,Evelyn  Yi Ting; Santos‑Banta,Sheryl  Lyn Lucero; Cheng,Chee  Leong; Tan,Leonard; Poon,Eileen  Yi Ling; Somasundaram,Nagavalli; Farid,Mohamad; Tang,Tiffany; Tao,Miriam; Khoo,James  Boon Kheng; Shih,Vivianne; Cheah,Daryl  Ming Zhe; Ong,Choon  Kiat; Lim,Soon  Thye; Chan,Jason  Yongsheng

doi:10.3892/mco.2019.1898

October-2019 Volume 11 Issue 4

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October-2019 Volume 11 Issue 4

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Case Report Open Access

Successful therapeutic rechallenge after a severe episode of high dose methotrexate‑induced choreoathetosis: A case report

Authors:
- Lip Leong Chong
- Evelyn Yi Ting Wong
- Sheryl Lyn Lucero Santos‑Banta
- Chee Leong Cheng
- Leonard Tan
- Eileen Yi Ling Poon
- Nagavalli Somasundaram
- Mohamad Farid
- Tiffany Tang
- Miriam Tao
- James Boon Kheng Khoo
- Vivianne Shih
- Daryl Ming Zhe Cheah
- Choon Kiat Ong
- Soon Thye Lim
- Jason Yongsheng Chan
View Affiliations / Copyright

Affiliations: Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Republic of Singapore, Department of Anatomical Pathology, Singapore General Hospital, Singapore 169608, Republic of Singapore, Department of Oncologic Imaging, National Cancer Centre, Singapore 169610, Republic of Singapore, Department of Pharmacy, National Cancer Centre Singapore, Singapore 169610, Republic of Singapore, Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore 169610, Republic of Singapore, Duke‑NUS Medical School, Singapore 169857, Republic of Singapore

Copyright: © Chong et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
Pages: 354-358
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Published online on: July 16, 2019

https://doi.org/10.3892/mco.2019.1898
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Abstract

Methotrexate (MTX) is an essential chemotherapy drug used in the treatment of malignancies, but it is known to cause complications to the central nervous system. We report a case of severe MTX neurotoxicity in an adult presenting with choreoathetosis despite a normal clearance of MTX. High dose‑MTX has been successfully rechallenged without any neurological sequelae. We reviewed the relevant literature of similar manifestations and summarized their clinical data, magnetic resonance imaging features and treatment given. None of them has recurrence of neurotoxicity. We concluded that it is safe to persist with MTX even after a previous episode of toxic leukoencephalopathy.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Successful therapeutic rechallenge after a severe episode of high dose methotrexate‑induced choreoathetosis: A case report

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