Osteoporosis methotrexate

In leukemia, the intensified use of methotrexate and glucocorticoids is responsible for causing an increased frequency of neurotoxicity and, in older children and adults, avascular necrosis of bone. High cumulative doses of anthracyclines can cause cardiomyopathy. Cranial irradiation causes neuropsychologic deficits and endocrine abnormalities that lead to obesity, short stature, precocious puberty, and osteoporosis.3 As newer and more intensive treatments enter clinical trials, close observation for long-term side effects will assume even greater importance.24... 

Methotrexate Nausea and vomiting diarrhoea fever anaphylaxis hepatic necrosis Oral and gastrointestinal ulceration, perforation may occur bone marrow depression hepatic toxicity including cirrhosis renal toxicity pulmonary infiltrates and fibrosis osteoporosis conjunctivFtis alopecia depigmentation menstrual dysfunction encephalopathy infertility lymphoma teratogenesis... 

The interpretation of the results is difficult because a number of the children had received other drugs, but in one child on methotrexate, hepato-splcnomegaly, osteoporosis, severe seoliosis and cirrhosis on percutaneous liver biopsy were noted. On discontinuing the methotrexate, many of these abnormal features returned to normal. The onset of osseous changes was insidious fractures, bone pain and osteoporosis were noted in 26 children, 15 had fractures of which 10 were in the lower extremity, osteoporosis was generalized in 2 and confined to the lower limbs in a further 2. 

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