Sahel Asgari, Narges Alizadeh, Shirin Zaresharifi, Mohaya Farzin
Catastrophic methotrexate toxicity, characterized by life-threatening pancytopenia and neutropenic enterocolitis, may occur even after a single low therapeutic dose, particularly in patients with renal impairment or dehydration. Early recognition and prompt multidisciplinary management are essential to improve outcomes.