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Female Gender and Hispanic Ethnicity are Associated with Increased Risk of Subacute Methotrexate Encephalopathy

Clara Y Lo, Cynthia Campen, Sandra Luna-Fineman, Norman J Lacayo, Paul G Fisher, Gary V Dahl

Subacute methotrexate (MTX) encephalopathy is poorly understood. We performed a historical cohort study of all cases of subacute MTX encephalopathy at Lucile Packard Children’s Hospital from January 1, 2005, to December 31, 2011. Of 272 patients receiving MTX, 21 patients were diagnosed with subacute MTX encephalopathy. Nine patients (42.9%) in this study were Hispanic females, whereas Hispanic females represented 56 of 272 (20.6%) total patients (p=0.0084). Further comparison with the 2010 California census confirms a Hispanic female predominance (p=0.032). We report a predominance of Hispanic females with subacute MTX encephalopathy, which suggests a genetic polymorphism that increases disease risk.