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
Related Articles
- EP ID EP570628
- DOI 10.26717/BJSTR.2017.01.000276
- Views 170
- Downloads 0
Effectiveness of Injectable Artesunate Versus Quinine in The Treatment of Severe Malaria in Children Aged 0-59 Months in Kenge, DRC
Malaria Threatens globally the lives of 3.3 trillion people living in 109 countries. This study compares the effectiveness avocation to of the drug artesunate versus quinine That of in the treatment of severe malaria Amo...
Impact of Aquatic Salinity on Mangrove Seedlings: A Case Study on Heritiera fomes (Common Name: Sundari)
Heritiera fomes (commonly known as Sundari in India) is gradually getting extinct from high saline pockets of lower Gangetic plain. Hydroponically grown seedlings of the species were analyzed for Chl a, Chl b, total chlo...
Initial Electrochemical Activity of Magnesium Alloy AZ31 Surface Exposed to Simulated Body Fluid by Scanning Electrochemical Microscopy
This study applies scanning electrochemical microscopy (SECM) in feedback mode to monitor the initial activity of AZ31 magnesium alloy surface, exposed to simulated body fluid (SBF). The alloy surface suffers a degradati...
Antioxidant Effect of Hydrogen Nanobubble Contributes to Suppression of Tumor Cell Growth
The antitumor effect of hydrogen nanobubble was evaluated in vitro and in vivo. Cancer cell growth was inhibited in the hydrogen nanobubble-containing medium compared to the non-containing medium (in vitro). Tumor growth...
Serum albumin conformation in patients with melancholic depression under antidepressant therapy
Discovery of biomarkers of mental disorders for evaluation of efficacy of psychopharmacotherapy is an important task. The last years it became clear that disturbances in molecular processes in pathological condi...