|
|
|
|
6 patients(age 3-16 years)who had methotrexate-induced neurotoxicity unresponsive to standard treatment received 2.5 mg/kg aminophylline.In addition,the concentration of adenosine in the cerebrospinal fluid(CSF) from 11 children completing a 24-h systemic methotrexate protocol was compared with that in 8 newly diagnosed patients and 12 who had not received any treatment for at least a week.4 of 6 patients with toxic signs and symptoms attributed to methotrexate and unrelieved by steroids, epidural blood patch,promethazine,5-hydrotryptamine antagonists, paracentamol,and narcotics,had complete resolution of neurotoxicity after or during a 1-h infusion of aminophylline;2 others had a pronounced improvement but persistent nausea.CSF adenosine concentrations of patients receiving methotrexate,even when there was very slight or no toxicity,were greatly increased compared with control subjects(mean values of 217 and 51 mol/L,median 175 and 52 nmol/L).Subacute methotrexate neurotoxicity may be mediated by adenosine and relieved by aminophylline. |
|