Severe bone marrow suppression following single-dose methotrexate treatment for ectopic pregnancy

Year 2017, Volume: 3 Issue: 3, 285 - 289, 04.11.2017

Betül Dündar , Burcu Dinçgez Çakmak , Gülten Özgen , Fatma Ketenci Gencer Burcu Aydın Boyama

https://doi.org/10.18621/eurj.304373

Abstract

Methotrexate is associated with multisystem side
effects which depend on the dosage, route of administration and length of
treatment. Bone marrow suppression is a very rare but one of the most mortal
complications. A case of severe bone marrow suppression following single dose
methotrexate for ectopic pregnancy was presented in this study. A 33-year-old woman,
diagnosed as ectopic pregnancy, was given single-dose intramuscular methotrexate
of 50 mg/m². On 10^th day patient was admitted with lethargy,
irritability, vomiting, hematemesis, diarrhea, oral mucositis and skin rash.
Laboratory findings revealed severe bone marrow suppression. Supportive
treatment together with antibacterial/ antifungal drugs and granulocyte colony
stimulating factors were administered. On the 3^rd day of treatment,
mucositis and oral intake began to improve. After 1 week complete blood count
was normal. Methotrexate may have mortal clinical consequences even with very
low doses. Therefore, a careful patient history for patient selection and
closer clinical follow-up are essential. 

Keywords

Bone marrow suppression, ectopic pregnancy, methotrexate, side effects, single-dose regimen

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