Severe Single Dose Methotrexate Neurological Toxicity after Treatment for Ectopic Pregnancy: A Case Report
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Severe methotrexate neurological adverse event due to medical treatment of an ectopic pregnancy is presented. Severe adverse effects are rare among patiens treated for ectopic pregnancy with MTX. , it should be used with caution and severe toxicity should be kept in mind with high index of awareness for any symptoms development after the treatment.Ectopic pregnancy is a serious, yet not uncommon condition in gynecologic practice. When treatment of an ectopic pregnancy is feasible by a medical means –the mainstay of treatment is by intramuscular injection of methotrexate (MTX) [1]. MTX treatment can be given by a single dose or by a multiple dose regimens. The single dose regimen is preferred usually due to is high efficacy, low adverse effect profile and low cost [2]. An adverse effect are usually mild and self-limited and has the incidence of about 10-30% [3]. Most common adverse effects are those effecting the mucosal tissue such as stomatitis and diarrhea. We hereby present a young healthy woman who had severe and rare neurological adverse event after single dose MTX treatment.A gravida 2 26 years old healthy women was admitted to our department with symptoms of lower abdominal pain and a positive pregnancy test. Her medical history revealed a spontaneous abortion at 1st trimester which was treated medically by a course of vaginal misoprostol. Her bHCG level was 1826. A pelvic ultrasound examination revealed a 6 mm endometrial thickness and a hypo echoic mass measuring 10 mm near the left ovary surrounded by fluid (Figure 1). A second bHCG level was 2453 and a diagnosis of an ectopic pregnancy was made. The women was treated with an intramuscular injection of 78 milligram of MTX and discharged free of symptoms or pain. BHCG levels declined to a level of 294 on day 7. On the 12 day after the treatment she presented to the emergency department with symptoms of bilateral paresthesia of the lower limbs which ascended to the pelvis. The symptoms worsened and progressed cephalic.
Authors and Affiliations
Gabriel Levin, Henry chill
Keywords
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- EP ID EP570628
- DOI 10.26717/BJSTR.2017.01.000276
- Views 147
- Downloads 0
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