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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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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. |
format | Online Article Text |
id | pubmed-6736458 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
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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