S Tomojiri | PubMed Health

PubMed2001

Methotrexate poisoning with acute hepatorenal dysfunction.

A 17-year-old girl receiving high-dose methotrexate for the treatment of osteosarcoma developed complications of acute renal failure and liver dysfunction with a coagulation disorder. The methotrexate concentrations were quickly reduced from 600 micromol/L to 50 micromol/L by treatment with plasma exchange and hemodialysis at 72 hours after discontinuation of the drug. After this reduction, continuous hemodiafiltration was initiated to further lower the methotrexate concentrations because of the persistently high and then the actual rebound in the plasma concentrations after plasma exchange and hemodialysis treatment. Continuous hemodiafiltration was able to reduce the concentrations without any rebound, despite its low column clearance. The rebound in plasma methotrexate concentrations seems to be corrected by plasma methotrexate after plasma exchange and/or hemodialysis.

Acute Kidney Injury↗

PubMed1999

Gas chromatographic-mass spectrometric analysis of dichlorobenzene isomers in human blood with headspace solid-phase microextraction.

Headspace solid-phase microextraction (HS-SPME) was utilized for the determination of three dichlorobenzene isomers (DCBs) in human blood. In the headspace at 30 degrees C, DCBs were absorbed for 15 min by a 100-micron polydimethylsiloxane (PDMS) fiber. They were then analyzed by capillary column gas chromatography-mass spectrometry (GC-MS). By setting the initial column oven temperature at 20 degrees C, the three isomers were resolved at the baseline level. p-Xylene-d10 was used as the internal standard (I.S.). For quantitation, the molecular ion at m/z 146 for each isomer and the molecular ion at m/z 116 for I.S. were selected. For day-to-day precision, relative standard deviations in the range 3.2-10.7% were found at blood concentrations of 1.0 and 10 micrograms/ml. Each compound was detectable at a level of at least 0.02 microgram per 1 g of whole blood (by full mass scanning). HS-SPME-GC-MS, when performed at relatively low temperatures, was found to be feasible in toxicological laboratories. Using this method, the plasma levels of one patient who had drunk a pesticide-like material were measured.

Adult↗