Gastrointestinal bleeding secondary to use of high-dose methotrexate: A case report

Abstract

A 69-year-old female patient was admitted to our emergency service with painful oral ulcers and rectal bleeding. She has been used methotrexate (MTX) because of rheumatoid arthritis (RA). The patient has been used methotrexate every day for 10 days instead of a weekly treatment. Pancytopenia was seen in laboratory tests. Rectal bleeding associated with gastrointestinal mucosal erosion was attributed to MTX toxicity and MTX-induced thrombocytopenia. The direct cause of MTX intoxication in this case was accidental daily use instead of a weekly use. This case demonstrates the importance of communicating adequately with health professionals and emphasizes that MTX should be used weekly. It is essential to describe in detail how the medication can be used and what adverse effects may occur as the result of taking MTX.

Fatal Neutropenic Enterocolitis Following Methotrexate Overdose: A Case Report

“…Tsukada et al (7) reported pancytopenia and gastrointestinal mucosal necrosis in a patient receiving 8 mg / week of MTX. Misuse of the dosage range was reported by Peker et al (8) with a case of GI bleeding and pancytopenia in a patient using MTX daily instead of weekly. The use of the wrong drug is one of the rarer causes of overdose side effects.…”

Thrombocytopenia and its effect on mortality and morbidity in the intensive care unit

“…In numerous studies, thrombocytopenia rates in the ICU varies between 35-45% and approximately half of these patients developed thrombocytopenia during intensive care hospitalization [9,10]. In the studies of Provan et al and Strauss et al, this rate was between 35% and 44%, and in the study conducted by Singh et al, thrombocytopenia rate was between 20-40% [11][12][13]. In our study, the rate of thrombocytopenia in the ICU was 30%, which was similar to the previous studies [14][15][16][17].…”

Infantile juvenile polyposis syndrome: A rare cause of protein-losing enteropathy

“…There are several reasons of rectal bleeding, including infections, medications, and inflammatory bowel disease [9]. One of the most common causes of painless, rectal bleeding in children is colorectal polyps, most of which are sporadic, usually isolated, colorectal juvenile polyps.…”