Choi Jiwon, Kang Mina, Hur Young Min, Kim Young Ju, Park Sunwha
Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Ewha Med J. 2023 Apr;46(2):e3. doi: 10.12771/emj.2023.e3. Epub 2023 Apr 30.
Ectopic pregnancy (EP) refers to blastocyst implantation outside the uterine endometrium. EP is major cause of maternal morbidity and mortality. Treatment options include surgery, medical therapy with methotrexate, or expectant management. Methotrexate is the primary regimen used in cases of early, unruptured ectopic pregnancies. Most side effects of methotrexate are minor, including nausea, vomiting, abdominal discomfort, and photosensitive skin reaction. Serious side effects, including bone marrow suppression, and pulmonary fibrosis, are invariably observed when methotrexate is administered in high doses with frequent dosing intervals, in chemotherapeutic protocols for malignancy. These side effects are uncommon with the doses used to treat ectopic pregnancies. Since cases of methotrexate-induced pancreatitis are rare, we report a case of pancreatitis in a patient with EP treated with methotrexate and expect to consider pancreatitis as a side effect of methotrexate in a patient with upper abdominal pain undergoing methotrexate chemotherapy.
异位妊娠（EP）是指胚泡在子宫内膜以外的部位着床。异位妊娠是孕产妇发病和死亡的主要原因。治疗选择包括手术、使用甲氨蝶呤的药物治疗或期待疗法。甲氨蝶呤是早期未破裂异位妊娠病例的主要治疗方案。甲氨蝶呤的大多数副作用较小，包括恶心、呕吐、腹部不适和光敏性皮肤反应。在恶性肿瘤的化疗方案中，当高剂量、频繁给药间隔使用甲氨蝶呤时，总会观察到严重的副作用，包括骨髓抑制和肺纤维化。这些副作用在用于治疗异位妊娠的剂量下并不常见。由于甲氨蝶呤诱发胰腺炎的病例很少见，我们报告一例接受甲氨蝶呤治疗的异位妊娠患者发生胰腺炎的病例，并期望在接受甲氨蝶呤化疗且出现上腹部疼痛的患者中考虑将胰腺炎视为甲氨蝶呤的副作用。
