@article{TEXTUAL,
      recid = {13609},
      author = {Berkemeyer, Andrea and Wagner, Ellen and Hashmat, Shireen  and Azzam, Ruba K.},
      title = {Methotrexate induced hepatotoxicity in metabolic  dysfunction-associated steatotic liver disease},
      journal = {JPGN Reports},
      address = {2024-09-05},
      number = {TEXTUAL},
      abstract = {Hepatotoxicity is an under-recognized and potentially  fatal side effect of high-dose methotrexate (HDMTX)  chemotherapy, and this risk is compounded in children with  metabolic dysfunction-associated steatotic liver disease  and/or metabolic-associated steatohepatitis. We present the  case of a 12-year-old obese, Hispanic male with elevated  hepatic transaminases of unknown etiology at initiation of  high-risk B-cell acute lymphoblastic leukemia chemotherapy.  He developed acute kidney injury within 24 hours of  receiving intravenous HDMTX which progressed to acute  hepatic failure. Liver biopsy confirmed methotrexate  toxicity aggravated by undiagnosed metabolic  dysfunction-associated steatotic liver disease. Rapid  deterioration precluded liver transplantation, and he died  21 days after HDMTX treatment. This case highlights the  need for comprehensive hepatic evaluation in patients with  known or suspected liver disease when administering HDMTX.  Dialysis should be considered if delayed methotrexate  clearance occurs due to potential for rapid, irreversible  hepatotoxicity.},
      url = {http://knowledge.uchicago.edu/record/13609},
}