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Low-dose methotrexate-induced vulvar edema: A case report

RATIONALE: Methotrexate (MTX) is an antimetabolite of folic acid, which is used for management of ectopic pregnancy. MTX-related toxicity may include cutaneous mucosal damage, bone marrow suppression, gastrointestinal disorders (gastritis, diarrhea, hematitis), liver and kidney function damage, pulm...

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Autores principales: Jia, Guifeng, Chai, Wei, He, Zhiwei, Liu, Xiaojing, Wen, Yan, Cui, Lifeng, Gong, Fengyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736458/
https://www.ncbi.nlm.nih.gov/pubmed/31464920
http://dx.doi.org/10.1097/MD.0000000000016895
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author Jia, Guifeng
Chai, Wei
He, Zhiwei
Liu, Xiaojing
Wen, Yan
Cui, Lifeng
Gong, Fengyan
author_facet Jia, Guifeng
Chai, Wei
He, Zhiwei
Liu, Xiaojing
Wen, Yan
Cui, Lifeng
Gong, Fengyan
author_sort Jia, Guifeng
collection PubMed
description RATIONALE: Methotrexate (MTX) is an antimetabolite of folic acid, which is used for management of ectopic pregnancy. MTX-related toxicity may include cutaneous mucosal damage, bone marrow suppression, gastrointestinal disorders (gastritis, diarrhea, hematitis), liver and kidney function damage, pulmonary toxicity, cardiac toxicity, and nerve toxicity. However, it is not usual for vulvar edema induced by low-dose methotrexate. PATIENT CONCERNS: In this case report, we described a patient with severe vulvar edema and oral cavity ulceration and scalp ulceration induced by low-dose MTX treatment for ectopic pregnancy. Her presenting complaints were pain in the vulva, oral cavity, and scalp. DIAGNOSES: The patient was diagnosed based on clinical findings for MTX toxic reactions. INTERVENTIONS: Vulva was disinfectioned with iodide and Kangfuxin solution, her mouth was rinsed with mouthwash. Three compound glycyrrhizin tablets were orally administered (3 times/day). After 10 days, the broken skin and mucous membrane healed. OUTCOMES: The vulvar edema and oral cavity ulceration and scalp ulceration healed. LESSONS: Our study demonstrated that even low-dose MTX can be induced skin and mucosal injury, patients and doctors should timely detection of drug toxicity reactions, immediately rescue, prompt discontinuation of medication, and symptomatic treatment to avoid accidental occurrence.
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spelling pubmed-67364582019-10-02 Low-dose methotrexate-induced vulvar edema: A case report Jia, Guifeng Chai, Wei He, Zhiwei Liu, Xiaojing Wen, Yan Cui, Lifeng Gong, Fengyan Medicine (Baltimore) 5600 RATIONALE: Methotrexate (MTX) is an antimetabolite of folic acid, which is used for management of ectopic pregnancy. MTX-related toxicity may include cutaneous mucosal damage, bone marrow suppression, gastrointestinal disorders (gastritis, diarrhea, hematitis), liver and kidney function damage, pulmonary toxicity, cardiac toxicity, and nerve toxicity. However, it is not usual for vulvar edema induced by low-dose methotrexate. PATIENT CONCERNS: In this case report, we described a patient with severe vulvar edema and oral cavity ulceration and scalp ulceration induced by low-dose MTX treatment for ectopic pregnancy. Her presenting complaints were pain in the vulva, oral cavity, and scalp. DIAGNOSES: The patient was diagnosed based on clinical findings for MTX toxic reactions. INTERVENTIONS: Vulva was disinfectioned with iodide and Kangfuxin solution, her mouth was rinsed with mouthwash. Three compound glycyrrhizin tablets were orally administered (3 times/day). After 10 days, the broken skin and mucous membrane healed. OUTCOMES: The vulvar edema and oral cavity ulceration and scalp ulceration healed. LESSONS: Our study demonstrated that even low-dose MTX can be induced skin and mucosal injury, patients and doctors should timely detection of drug toxicity reactions, immediately rescue, prompt discontinuation of medication, and symptomatic treatment to avoid accidental occurrence. Wolters Kluwer Health 2019-08-30 /pmc/articles/PMC6736458/ /pubmed/31464920 http://dx.doi.org/10.1097/MD.0000000000016895 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 5600
Jia, Guifeng
Chai, Wei
He, Zhiwei
Liu, Xiaojing
Wen, Yan
Cui, Lifeng
Gong, Fengyan
Low-dose methotrexate-induced vulvar edema: A case report
title Low-dose methotrexate-induced vulvar edema: A case report
title_full Low-dose methotrexate-induced vulvar edema: A case report
title_fullStr Low-dose methotrexate-induced vulvar edema: A case report
title_full_unstemmed Low-dose methotrexate-induced vulvar edema: A case report
title_short Low-dose methotrexate-induced vulvar edema: A case report
title_sort low-dose methotrexate-induced vulvar edema: a case report
topic 5600
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736458/
https://www.ncbi.nlm.nih.gov/pubmed/31464920
http://dx.doi.org/10.1097/MD.0000000000016895
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