CLINICAL CASE OF METHOTREXATE SIDE EFFECT

Abstract

Methotrexate is a cytostatic drug from the group of folic acid antagonists, which inactivates dihydrofolate reductase and reduces the level of tetrahydrofolate, which leads to blocking of cell division and their irreversible damage. Due to this mechanism of action, methotrexate has a wide range of applications in medical practice. However, there are some risks of developing side effects, which can manifest themselves both in the form of mild symptoms, including nausea, vomiting, fever, and in the form of severe conditions with myelosuppression and pancytopenia. This article reflects a clinical case of a side effect of methotrexate when it is used in gynecological practice for the purpose of conservative treatment of a patient with an intact tubal pregnancy. The aim of the study. To analyze a clinical case of the use of methotrexate in gynecological practice for the treatment of damaged tubal disease, and its side effects. Materials and methods. The medical history of a patient with an intact tubal pregnancy, who was administered methotrexate with the appointment of conservative treatment, was analyzed. Results and discussion. This article reflects a clinical case of a side effect of methotrexate when it is used in gynecological practice for the purpose of conservative treatment of a patient with an intact tubal pregnancy. On the 3rd day after the administration of the second dose of methotrexate, the patient developed manifestations of urticaria, pharyngitis, stomatitis, agranulocytosis, hyperthermia. A consultation of doctors diagnosed a side effect of methotrexate. Over the following weeks, the patient's condition gradually worsened: pancytopenia increased, pneumonia developed, and secondary skin lesions appeared. Conclusions. Only an individual approach to each patient, taking into account all clinical symptoms and monitoring the general condition and hemostasis indicators, will allow timely detection of side effects of the drug. Timely correction of changes in the general condition will allow achieving complete recovery of the patient.