Case report on toxicity of methotrexate in tubal ectopic pregnancy

Abstract

Ectopic pregnancy is defined as pregnancy outside uterine cavity. Of all ectopic pregnancy, tubal ectopic is most common. Most cases today are diagnosed early and hence timely treatment is possible. In stable patients, medical line of management with methotrexate can be used. With early diagnosis and medical line of treatment, use of injectable methotrexate is on rise. Being aware of characteristics of methotrexate like mechanism, dosage, side effects and contraindications, appropriate patient selection and watchful monitoring will help reduce methotrexate induced toxicity.

Methotrexate-induced toxidermia and pancytopenia in a patient with ectopic pregnancy: a case report

“…[ 4 , 7 ]. The patient presented with fever, as with the majority of cases reported in the literature [ 3 , 4 , 6 – 8 ]. The patient presented with generalized phlyctenular maculopapular rashes associated with purpuric lesions and cutaneous jaundice.…”

“…The patient was anemic on admission as was the case for most of the cases reported in the literature [ 3 , 5 , 8 ]. As in our case, pancytopenia seems constant during severe reactions to MTX [ 3 , 4 , 6 – 8 ]. Our patient presented with febrile neutropenia as in the cases reported by Shao et al.…”

“…in India and by Shao et al. in Taiwan, which were respectively 2 days and 3 days [ 3 , 4 ]. This period is shorter than in the cases reported by Toujani et al.…”

“…In the case reported by Lodha et al. , the patient presented with plate and ulcerated generalized lesions, friable, and bleeding on contact [ 3 ]. In the case reported by Soysal et al.…”

“…in Tunisia and by Lodha et al. in India [ 3 , 6 ]. These mucosal lesions appear to be of varying degrees, ranging from erythema of the oral mucosa to bleeding ulcers of the digestive tract [ 5 , 7 ].…”