Table 3:Causes for MTX toxicity in each case.
No | age [y] | disease | MTX-dosage[mg/w] | Reason of toxicity | GFR before[ml/min] | Minimal GFR[ml/min] | Cofactors | Relevant comedication | Toxicity | Outcome |
1 | 57 | RA | 150 | Dose error | 90 | 90 | Pancytopenia, mucositis,pneumonia | Died | ||
2 | 73 | RA | 15 | ARF on CRF II | 72 | 40 | LEF, ARB | Leukopenia,thrombocytopenia | Recovery | |
3 | 43 | RA | 105 | dose error | 90 | 90 | Previous diarrhea | Pancytopenia,mucositis | Recovery | |
4 | 53 | pSS | 15 | ARF | 68 | 20 | Unkown LCDD | Pancytopenia | Recovery | |
5 | 66 | PS | 12.5 | CRF IV | 29 | 27 | ARB, LD | Leucopenia,mucositis | Recovery | |
6 | 75 | RA | 15 | CRF IV | 28 | 24 | Use of painkiller | ACE | Pancytopenia, mucositis,pneumonia | Died |
7 | 79 | RA | 15 | ARF on CRF II | 65 | 37 | Diarrhea (Noro-Virus) | NSAID, ACE | Pancytopenia | Recovery |
8 | 54 | RA | 15 | ARF on CRF Ill | 58 | 36 | Acute interstitial nephritis | Pancytopenia, mucositis | Recovery | |
9 | 55 | RA | 15 | ARF | 92 | 36 | ACE | Leucopenia, anemia, pneumonia | Recovery | |
10 | 82 | RA | 15 | ARF on CRF Ill | 55 | 24 | Pancytopenia, mucositis,fever,soor esophagitis | Recovery | ||
11 | 71 | AAV | 15 | ARF on CRF Ill | 59 | 43 | Infection with fever | ARB, HCT | Pancytopenia,mucositis,pneumonia | Recovery |
12 | 78 | RA | 15 | ARF on CRF 111 | 53 | 21 | Pancytopenia, pneumonia | Recovery | ||
13 | 83 | RA | 15 | ARF on CRF Ill | 51 | 32 | ARB | Pancytopenia | Recovery | |
14 | 64 | RA | 70 | dose error | 90 | 90 | Urinary retention | Pancytopenia | Recovery | |
15 | 84 | RA | 7.5 | ARF on CRF II | 66 | 15 | Infection with fever | ACE, COX | Pancytopenia,mucositis,diarrhea | Recovery |
16 | 66 | RA | 15 | ARF | 90 | 31 | ACE, TOC | Pancytopenia | Recovery | |
17 | 68 | PSA | 15 | unclear | 90 | 90 | Acute interstitial nephritis | LEF | Panzytopenia, mucositis | Recovery |
18 | 78 | pSS | 15 | ARF on CRF Ill | 55 | 38 | Previous diarrhea | Pancytopenia | Recovery | |
19 | 61 | RA | 15 | ARF | 90 | 10 | ARB, NSAID, HGT | Pancytopenia | Recovery | |
20 | 62 | RA | 30 | ARF on CRF II and dose error | 83 | 54 | Previous diarrhea | LEF, NSAID | Pancytopenia, mucositis, pneumonia | Recovery |
21 | 72 | PS | 22.5 | CRF IV | 28 | 27 | LD | Leucopenia,thrombocytopenia,mucositis | Recovery | |
22 | 89 | RA | 90 | CRF IV and dose error | 20 | 18 | Pancytopenia, mucositis, pneumonia | Died |
ARF: acute renal failure, CRF (2-4): chronic renal failure (stage 2-4), LCDD: light chain deposition disease, Medication: LEF: leflunomide, TOC: tocilizumab,
ARB: angiotensin receptor blocker; ACE: ACE-inhibitor, LD: loop diuretics, HCT: hydrochlorothiazide, NSAID: nonsteroidal antiinflammatory drugs, COX: cyclooxygenase II-inhibitor.