Yüksek doz metotreksat kullanımına ikincil gelişen gastrointestinal kanama: Olgu sunumu

Öz

69 yaşında kadın hasta Acil Servis’ e ağrılı oral ülserler ve rektal kanama ile başvurdu. Romatoid artrit (RA) sebebiyle metotreksat (MTX) kullanıyordu ve haftalık tedavi yerine 10 gün boyunca her gün olacak şekilde MTX kullanmıştı. Labaratuvar testlerinde pansitopeni görüldü. Gastrointestinal mukozal hasar birlikteliği ile olan rektal kanaması MTX toksisitesine ve MTX bağımlı trombositopeniye bağlandı. Bu olguda MTX intoksikasyonunun direkt sebebi haftalık kullanım yerine yanlışlıkla günlük olarak kullanım idi. Bu vaka sağlık çalışanları ile yeterli iletişim kurmanın önemini göstermektedir ve MTX’ın haftalık olarak kullanılması gerektiğini vurgulamaktadır. MTX tedavisi başlanacağı zaman detaylı bir şekilde ilacın nasıl kullanılacağı ve hangi yan etkileri oluşturabileceğini anlatmak elzemdir.

Anahtar Kelimeler

• Metotreksat,Romatoid artrit,Trombositopeni

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.

Keywords

• Methotrexate,Rheumatoid arthritis,Thrombocytopenia

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