Methotrexate (MTX) is widely used as an immunosuppressant, chemotherapeutic, and abortifacient agent. It is also a potent teratogen, and intentional or unintentional exposure during pregnancy is associated with heterogeneous birth anomalies. We retrospectively reviewed a cohort of patients who presented to our clinic with limb anomalies in the setting of MTX embryopathy. In our case series, we describe 7 cases of patients who had limb anomalies with heterogeneous functionality, from severely debilitating to completely asymptomatic. Most of the upper extremity anomalies in our group were managed conservatively. Methotrexate embryopathy is a rare but clinically important entity with phenotypic and functional variability. This series underscores the need for proper counseling of patients and raises concern regarding using this medication for the purpose of abortion.
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http://dx.doi.org/10.1177/1558944719837657 | DOI Listing |
Autoimmune rheumatic diseases (ARDs) often affect women during their reproductive years, and early studies of pregnancy in these patients reported high rates of adverse outcomes. Continuation or initiation of safe and effective medications in the preconception period is beneficial for maintaining or achieving disease quiescence throughout pregnancy thereby improving both maternal and pregnancy outcomes. The European Alliance of Associations for Rheumatology, the American College of Rheumatology, and the British Society for Rheumatology have published recommendations and guidelines regarding management of ARDs during pregnancy.
View Article and Find Full Text PDFGastroenterology
October 2024
Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon.
Iran J Med Sci
July 2024
Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan.
View Article and Find Full Text PDFPaediatr Perinat Epidemiol
August 2024
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Oxf Med Case Reports
June 2024
Rheumatology Department, National Center for Rheumatic Diseases, House no 158, Pashupati Sadak, Kathmandu-9, 44600, Nepal.
Pyomyositis is a purulent infection of skeletal muscle that is mostly observed in tropical countries. Aseptic pyomyositis is a rare, potentially life-threatening disorder characterized by the formation of sterile pus in muscle. We present a case of 53-years old female, diagnosed case of seropositive rheumatoid arthritis, presented with pain and swelling of the right calf muscle for 2 weeks.
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