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Chemical pleuritis as the cause of acute chest pain following high‐dose methotrexate treatment
Author(s) -
Urban Christian,
Nirenberg Anita,
Caparros Brenda,
Anac Sarkis,
Cacavio Adrienne,
Rosen Gerald
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19830101)51:1<34::aid-cncr2820510109>3.0.co;2-s
Subject(s) - medicine , methotrexate , chest pain , anesthesia , surgery
This report describes the clinical and roentgenographic features of a pleuritis seen following the administration of high‐dose methotrexate (HDMTX). Among 210 patients who received 3130 courses of HDMTX from 1977 through 1980, the incidence of this clinical entity was 8.5% (n = 18). The sudden onset of chest pain occurred only after the third or fourth HDMTX treatment and usually lasted between three and five days; the pain was often quite severe and led to extensive clinical examination before recognition of the benign transient nature of this syndrome. Roentgenographic examination of the chest revealed thickening of the intra lobar pleura, most prominent on the right side. Our observations support the hypothesis that this adverse drug reaction occurs more frequently than assumed, but is often ignored or misinterpreted.