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A Rare Drug Reaction to Methotrexate After Treatment for Ectopic Pregnancy

Straka, Michele DO*; Zeringue, Ernest MD*; Goldman, Mindy MD

doi: 10.1097/01.AOG.0000127941.83892.e1
Case Reports

BACKGROUND: Ectopic pregnancies are commonly diagnosed and treated in physicians’ offices. In the hemodynamically stable patient, therapy often includes treatment with methotrexate. Well-known adverse effects of this drug include mucositis, abdominal cramping, and malaise. We report a case of a rare drug reaction after treatment with methotrexate.

CASE: A 34-year-old, gravida 2, para 0, at 7 weeks of gestation by last menstrual period was diagnosed with an ectopic pregnancy and treated with methotrexate. The patient had an anaphylactoid reaction shortly after administration of methotrexate.

CONCLUSION: Methotrexate is a commonly used therapy for ectopic pregnancies in the outpatient setting. Practitioners should be aware of the potential adverse reactions to methotrexate.

An unusual anaphylactoid reaction to a commonly used medication is reported.

*David Grant Medical Center, Travis Air Force Base, California; and †University of California, San Francisco Medical Center, San Francisco, California

Address reprint requests to: Michele Straka, DO, David Grant Medical Center, 101 Bodin Circle, SGCG, Travis, AFB CA 94535-1800; e-mail:

The views in this article do not reflect the views of the U.S. Air Force.

Received January 28, 2003. Received in revised form May 8, 2003. Accepted May 27, 2003.

© 2004 The American College of Obstetricians and Gynecologists