SEVERE BONE MARROW SUPPRESSION FOLLOWING SINGLE-DOSE METHOTREXATE TREATMENT FOR ECTOPIC PREGNANCY

BETÜL DÜNDAR, BURCU DİNÇGEZ ÇAKMAK, GÜLTEN ÖZGEN, FATMA KETENCİ GENCER, BURCU AYDIN BOYAMA

The European Research Journal - 2017;3(3):285-289

Department of Obstetrics and Gynecology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

 

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 10th 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 3rd 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. Eur Res J 2017;3(3):285-289