Acta Medica Okayama volume74 issue6
2020-12 発行

Delayed Methotrexate Elimination after Administration of a Medium Dose of Methotrexate in a Patient with Genetic Variants Associated with Methotrexate Clearance

Tatebe, Yasuhisa Department of Pharmacy, Okayama University Hospital
Kanamitsu, Kiichiro Department of pediatrics, Okayama University Hospital
Kanzaki, Hirotaka Department of Pharmacy, Okayama University Hospital
Ishida, Hisashi Department of pediatrics, Okayama University Hospital
Fujiwara, Kaori Department of pediatrics, Okayama University Hospital
Washio, Kana Department of pediatrics, Okayama University Hospital
Kitamura, Yoshihisa Department of Pharmacy, Okayama University Hospital ORCID Kaken ID publons researchmap
Sendo, Toshiaki Department of Pharmacy, Okayama University Hospital Kaken ID publons researchmap
Shimada, Akira Department of pediatrics, Okayama University Hospital ORCID Kaken ID researchmap
Tsukahara, Hirokazu Department of pediatrics, Okayama University Hospital Kaken ID publons researchmap
Publication Date
2020-12
Abstract
Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner.
Document Type
Case Report
Keywords
methotrexate
polymorphism
drug elimination
acute kidney injury
acute lymphoblastic leukemia
Link to PubMed
74_6_545.pdf 2.12 MB