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This case presents a situation of severe mucositis induced by methotrexate treatment, emphasizing its potential severity.

A78-23 Severe Methotrexate Induced Mucositis Requiring Intubation

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Case report demonstrates severe mucositis from methotrexate in an older woman, highlighting treatment challenges.

This case presents a situation of severe mucositis induced by methotrexate treatment, emphasizing its potential severity.
Patient presented with oral ulcers after starting methotrexate for psoriatic arthritis.
She was intubated for hypoxic respiratory failure and transferred to ICU.
Mucositis was treated with leucovorin and supportive care, including Heliox.
Patient developed grade 4 mucositis requiring intubation due to severe respiratory distress.
Treatment resulted in gradual improvement of airway status and mucositis with successful extubation.
Mucosal recovery was near complete at the time of discharge from the hospital.

Khan et al. (2026) studied this question.

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