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Methotrexate-induced pericarditis and pericardial effusion; first reported case
L N Forbat1, B W Hancock, A H Gershlick
1Department of Medicine, Good Hope Hospital NHS Trust, Sutton Coldfield, UK.
Postgraduate Medical Journal
|April 1, 1995
Summary
Methotrexate therapy can cause pericarditis and pericardial effusion, particularly in pregnant women. This case highlights rare, isolated cardiac complications linked to this common drug.
Area of Science:
- Cardiology
- Rheumatology
- Obstetrics
Background:
- Methotrexate is a widely used medication for autoimmune diseases and cancers.
- Cardiac complications of methotrexate are rare, with most literature focusing on other toxicities.
- Pregnancy presents unique physiological changes that may alter drug responses.
Observation:
- A 22-year-old pregnant woman developed pericarditis and pericardial effusion.
- These cardiac events occurred during methotrexate therapy.
- No other concurrent medical conditions or drug exposures were identified as causative.
Findings:
- This case presents the first documented instance of isolated pericarditis and pericardial effusion as a direct consequence of methotrexate treatment.
- The patient's presentation suggests a direct toxic effect of methotrexate on the pericardium.
- The specific mechanisms underlying methotrexate-induced pericardial disease remain to be elucidated.
Implications:
- Clinicians should consider methotrexate-induced pericarditis in pregnant patients presenting with cardiac symptoms.
- Further research is warranted to understand the incidence and pathophysiology of methotrexate-related cardiac events.
- This finding may necessitate revised monitoring protocols for pregnant patients on methotrexate therapy.