OLGU SUNUMLARI
Dikkat: Kronik Renal Yetmezliği Olan Kadınlarda Ektopik Gebelik Tedavisinde Tek, Düşük Doz Metotreksat Bile Ciddi Yan Etkiler Yapabilir: Bir Olgu Sunumu
Caution: Even in A Single-Low Dose Methotrexate for Treatment of Ectopic Pregnancy Could Have Severe Adverse Effects in Women with Chronic Renal Insufficiency: A Case Report
Received Date : 14 Dec 2020
Accepted Date : 06 Jan 2021
Available Online : 25 Aug 2021
Gülnaz ŞAHİNa, Ferruh ACETa b Ege Nazan TAVMERGEN GÖKERa b, Erol TAVMERGENa b
aEge Üniversitesi Aile Planlaması ve İnfertilite Araştırma ve Uygulama Merkezi, İzmir, TÜRKİYE
bEge Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, İzmir, TÜRKİYE
Doi: 10.24074/tjrms.2020-80598 - Makale Dili: EN
TJRMS. 2021;5(2):66-9
ÖZET
Bu olgu sunumunda, kronik renal yetmezlik nedeniyle hemodiyaliz olan ve ektopik gebelik için tek, düşük doz metotreksat (Mtx) uygulaması sonrası
şiddetli oral mukozit, cilt döküntüsü ve kemik iliği supresyonu geliştiren bir hasta bildirilmiştir. Böbrek yetmezliği olan hastalarda düşük dozda
bile olsa Mtx’den kaçınılmalıdır
Anahtar Kelimeler: Ektopik gebelik, metotreksat, böbrek yetmezliği, kemik iliği depresyonu
ABSTRACT
In this case report, a patient on hemodialysis due to chronic renal insufficiency and developed severe oral mucositis, skin rash and bone marrow
suppression after being treated with single low-dose methotrexate (Mtx) for ectopic pregnancy was reported. Mtx even in low dose should be
avoided in patients with renal insufficiency.
Keywords: Ectopic pregnancy, methotrexate, renal insufficiency, bone marrow suppression
REFERANSLAR
- Barnhart K, Coutifaris C, Esposito M. The pharmacology of methotrexate. Expert Opin Pharmacother. 2001;2(3):409-17. [Crossref]
- Cheung KK, Chow KM, Szeto CC, Tai MH, Kwan BC, Li PK. Fatal pancytopenia in a hemodialysis patient after treatment with low-dose methotrexate. J Clin Rheumatol. 2009;15(4):177-80. [Crossref]
- Spencer K, Enofe O, Cowans NJ, Stamatopoulou A. Is maternal renal disease a cause of elevated free β‐hCG in first trimester aneuploidy screening? Prenat Diagn 2009;29(11):1045-9. [Crossref]
- Willner N, Storch S, Tadmor T, Schiff E. Almost a tragedy: severe methotrexate toxicity in a hemodialysis patient treated for ectopic pregnancy. Eur J Clin Pharmacol. 2014;70(3):261-3. [Crossref]
- Kelly H, Harvey D, Moll S. A cautionary tale: fatal outcome of methotrexate therapy given for management of ectopic pregnancy. Obstet Gynecol. 2006;107(2 Pt 2):439-41.Erratum in: Obstet Gynecol. 2006;107(5): 1171. [Crossref]
- Murashima M, Adamski J, Milone MC, Shaw L, Tsai DE, Bloom RD. Methotrexate Clearance by High-Flux Hemodialysis and Peritoneal Dialysis: A Case Report. Am J Kidney Dis. 2009;53:871-4 [Crossref]
- Benachi A, Dreux S, Kaddioui-Maalej S,et al. Down syndrome maternal serum screening in patients with renal disease. Am J Obstet Gynecol. 2010;203(1):60.e1-4. [Crossref]
