Severe nephrotoxicity during high-dose methotrexate administration in an adolescent with acute lymphoblastic leukemia

High-dose methotrexate is an effective and safe therapy. It is included in the treatment regimens of various hematologic and oncologic diseases. The acute and severe toxicity of this chemotherapeutic agent is unusual. Nephrotoxicity occurs in about 2-12% of patients, associated with a slow clearance of the drug. It is usually reversible but requires an early approach. The objective was to describe the case of a patient diagnosed with lymphoblastic leukemia who presented with acute kidney injury after the administration of high doses of methotrexate.