{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:48:09Z","timestamp":1789832889133,"version":"4.0.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Methotrexate (MTX) is a versatile drug used in various fields, including oncology and rheumatology, acting by inhibitory effects on DNA synthesis and cellular replication. While low-dose MTX is a first-line treatment for rheumatoid arthritis and psoriasis, overdose or incorrect dosing can lead to severe toxicity. We present three cases of accidental MTX poisoning, highlighting the diverse clinical manifestations and challenges in management. Patients presented with fever, weakness, mucocutaneous lesions, and pancytopenia, necessitating intensive care and supportive treatment. These cases underscore the importance of proper dosing, patient education, and pharmacist vigilance to prevent medication errors. Heightened awareness among clinicians is crucial to promptly recognize and manage MTX toxicity, ensuring the safe and effective use of this valuable therapeutic agent. Further research is needed to optimize dosing strategies and enhance safety measures for MTX administration.<\/jats:p>","DOI":"10.4103\/ijp.ijp_363_24","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:00:44Z","timestamp":1752073244000},"page":"196-199","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Acute accidental methotrexate poisoning: Fatal consequences \u2013 An Indian experience"],"prefix":"10.4103","volume":"57","author":[{"given":"Mauli M.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Dermatology, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya K","family":"Ghoghara","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shree","family":"Dhanani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyur","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragya A.","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"9056086","DOI":"10.1155\/2018\/9056086","article-title":"A rapidly fatal case of low-dose methotrexate toxicity","volume":"2018","author":"Shaikh","year":"2018","journal-title":"Case Rep Med"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"1537689","DOI":"10.1155\/2020\/1537689","article-title":"A review of clinical applications and side effects of methotrexate in ophthalmology","volume":"2020","author":"Wang","year":"2020","journal-title":"J Ophthalmol"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"64","DOI":"10.4103\/idoj.IDOJ_157_18","article-title":"Acute methotrexate toxicity due to overdosing in psoriasis: A series of seven cases","volume":"10","author":"Pradhan","year":"2019","journal-title":"Indian Dermatol Online J"},{"key":"R4-20260421","first-page":"e30659","article-title":"A fatal fate: A medical error leading to acute methotrexate toxicity","volume":"14","author":"Khan","year":"2022","journal-title":"Cureus"},{"key":"R5-20260421","first-page":"e29518","article-title":"Overview of methotrexate toxicity: A comprehensive literature review","volume":"14","author":"Hamed","year":"2022","journal-title":"Cureus"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"97","DOI":"10.47102\/annals-acadmedsg.V40N2p97","article-title":"A case of acute methotrexate toxicity","volume":"40","author":"Tan","year":"2011","journal-title":"Ann Acad Med Singap"},{"key":"R7-20260421","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s12288-019-01144-3","article-title":"Serum methotrexate level and side effects of high dose methotrexate infusion in pediatric patients with acute lymphoblastic leukaemia (ALL)","volume":"36","author":"Sajith","year":"2020","journal-title":"Indian J Hematol Blood Transfus"},{"key":"R8-20260421","first-page":"e67","article-title":"Accidental chronic poisoning with methotrexate; report of two cases","volume":"5","author":"Bidaki","year":"2017","journal-title":"Emerg (Tehran)"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3390\/toxics10100572","article-title":"Toxicological aspects of methotrexate intoxication: Concentrations in postmortem biological samples and autopsy findings","volume":"10","author":"Szpot","year":"2022","journal-title":"Toxics"}],"container-title":["Indian Journal of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_363_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:51:28Z","timestamp":1786647088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_363_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijp.ijp_363_24","relation":{},"ISSN":["0253-7613","1998-3751"],"issn-type":[{"value":"0253-7613","type":"print"},{"value":"1998-3751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2024-05-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}