接受甲氨蝶呤治疗类风湿关节炎的患者出现不明原因闭经。
Unexplained amenorrhea in a patient taking methotrexate for the treatment of rheumatoid arthritis.
机构信息
Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Toronto, Ontario, Canada.
出版信息
Gynecol Endocrinol. 2010 Mar;26(3):179-80. doi: 10.3109/09513590903215573.
BACKGROUND
The cause of secondary amenorrhea in the following case cannot be explained by traditional etiologies. We therefore questioned whether long-term methotrexate treatment played a role as an endometrial inhibitor.
CASE
A 44-year-old G4P2, with a 5-year history of rheumatoid arthritis, presented with a 2-year history of secondary amenorrhea. The patient took methotrexate since diagnosis. Her FSH, estrogen, prolactin, TSH and T4 levels were normal, her B-HCG was negative, her BMI was 22 and she had no history of Asherman's syndrome.
CONCLUSION
There is no information, based on our search, on whether long-term methotrexate treatment has an effect on the menstrual cycle. This case highlights the need for the elucidation of the effects of long-term methotrexate treatment on the menstrual cycle in patients with rheumatoid arthritis.
背景
本例继发性闭经的原因不能用传统病因解释。因此，我们怀疑长期甲氨蝶呤治疗是否作为一种子宫内膜抑制剂发挥作用。
病例
一位 44 岁 G4P2，类风湿关节炎病史 5 年，出现继发性闭经 2 年。患者自确诊以来一直服用甲氨蝶呤。她的 FSH、雌激素、催乳素、TSH 和 T4 水平正常，B-HCG 阴性，BMI 为 22，无 Asherman 综合征病史。
结论
根据我们的检索，没有关于长期甲氨蝶呤治疗是否对月经周期有影响的信息。本例强调了需要阐明类风湿关节炎患者长期甲氨蝶呤治疗对月经周期的影响。
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