Unraveling the Consequences; Methotrexate Induced Abnormal Uterine Bleeding: A New Case Report
DOI:
https://doi.org/10.37506/2khvc592Keywords:
DMARDs, Methotrexate Abdominal Uterine Bleeding, Hysteroscopy, Polypectomy, Rheumatoid Arthritis.Abstract
A 49 year old female patient was admitted in a tertiary care hospital with complaints of heavy menstrual bleeding and breathlessness on exertion and fatigue. Her personal history was 15- 20 pads per day, fully soaked/ clot+ 5-6 days. She had medical history of Rheumatoid Arthritis for 2 years and was taken Disease Modifying Anti- Rheumatic Drugs (DMARDs). Ultrasound abdomen showed bulky uterus due to improper dosing and monitoring DMARDs, especially for Methotrexate which was weekly once regimen took twice daily, lead to alteration in progestrone and estrogen level, resulted in Abnormal Uterine Bleeding. Plan of care was primarily withhold DMARDs and undergone Hysteroscopy guided with Polypectomy, D & C (Dilation and Curettage). At the time of discharge, the patient was stable and decided to consult Rheumatologist outside.
References
Pharmacotherapy 5th edition by Joseph T Dipiro, et al 2002: 1463- 1480, 1623-1638
Janet R Albers, et al.Abnoraml Uterine Bleeding. American Family Physician. 2004; 69(8): 1915-26
Emily Davis, et al. Abnormal Uterine Bleeding. National Library of Medicine. 2023
Onecia Benjamin, et al. Disease- Modifying Anti-rheumatic Drugs (DMARD). National Library of Medicine. 2023
Maryam Hanoodi, et al. Methotrexate. National Library of Medicine. 2023
Mitchell D. Creinin, et al. Methotrexate Effects on Trophoblast and the Corpus Luteum in Early Pregnancy. American Journal of Obstetrics and Gynaecology. 1998; 179(3): 604-609
Maria P Yavropoulou, et al. Immune System Effect on Endocrine System. National Library of Medicine. 2023
Dala N Daraghmeh, et al. Female Reproductive Status and Exogenous Sex Hormone use in Rheumatoid Arthritis Patients treated with Tocilizumab and csDMARDs. Rheumatology (Oxford) Journal. 2023; 62(2): 583-95
Mesut Ogrendik. Antibiotics for the treatment of Rheumatoid Arthritis. International Journal of Medicine. 2013; 7: 43-47
Jacqueline Bullock, et al. Rheumatoid Arthritis: A Brief Overview of the treatment. Medical Principles and Practice. 2018; 27: 501-07
Reesha Gupta, et al. Advancement in the management of Rheumatoid Arthritis. RPS Pharmacy and Pharmacology Reports. 2023; 2(1): 1-7
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Copyright (c) 2025 Abhirami Rajasekhar, Adithyan R S, Dhanya Dharman, Shaiju S Dharan
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