We report an unusual case of anaphylaxis and hepatitic dysfunction in a child with the administration of the twenty‐third course of high‐dose methotrexate. The latter had been used as an adjuvant to prevent pulmonary metastases and the prior 22 courses had been well tolerated. An attempt to reinstate methotrexate after the twenty‐third course was again followed by a similar reaction. © 1995 Wiley‐Liss, Inc.
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