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

• Published in: The European research journal Vol. 3; no. 3; pp. 285 - 289
• Main Authors: Dündar, Betül, Dinçgez Çakmak, Burcu, Özgen, Gülten, Ketenci Gencer, Fatma, Aydın Boyama, Burcu
• Format: Journal Article
• Language: English
• Published: Bursa The Association of Health Research & Strategy 29.08.2017
• Subjects: Bone marrow; Pregnancy complications
• DOI: 10.18621/eurj.304373
• ISSN: 2149-3189

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.