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Hepatotoxic effect and lack of efficacy: case report An approximately 55-year-old woman developed hepatotoxic effect during treatment with methotrexate for cutaneous T-cell lymphoma. Additionally, she exhibited lack of efficacy while receiving interferon and methotrexate for cutaneous T-cell lymphoma [routes and duration of treatment to reaction onset not stated; not all dosages stated]. The woman (born in 1963) had took part in the liquidation of the Chernobyl nuclear disaster. In February 2018, she presented with rash on the skin of the limbs, face and trunk. Previously, she was treated with unspecified antihistamines and topical corticosteroids with transient improvement. Following investigations, in March 2018, the diagnosis of cutaneous T-cell lymphoma, presenting as Mycosis fungoides (mycotic stage) was made. She was thus treated with interferon from April 2018 to July 2018. However, no apparent improvement was observed. Therefore, she started receiving methotrexate 30mg per week along with methylprednisolone. However, her condition worsened. Additionally, she exhibited elevated biochemical parameters (ALT 169 U/L), which indicated hepatotoxic effect of methotrexate. The woman’s dose of methotrexate was therefore decreased to 20mg per week, and eventually, methotrexate was stopped. Also, PUVA therapy was recommended. After discontinuation of methotrexate, her biochemical parameters normalised. Laboratory findings showed serum total protein 72 g/L, bilirubin total 20.8 µmol/L, bilirubin direct 5.7 µmol/L, ALT 33.4 U/L, AST 30.9 U/L, urea 2.74 mmol/L, creatinine 74.5 mmol/L and alkaline phosphatase 39 U/L. Hrechanska LV, et al. CLINICAL CASE OF CUTANEOUS T-CELL LYMPHOMA IN A PATIENT WHO GOT INJURED AFTER THE DISASTER ON CHORNOBYL NUCLEAR POWER PLANT. Problemi Radiacijnoi Medicini Ta Radiobiologii 24: 516-521, 2019. Available from: URL: http:// 803497925 doi.org/10.33145/2304-8336-2019-24-516-521

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Reactions 22 Aug 2020 No. 1818