Haematemesis and Malaena – Rare Presentations of Methotrexate Toxicity - A Case Report

Abstract

Methotrexate is a mysterious compound with unknown pharmacokinetics. It is primarily used in many conditions like cancers, psoriasis, rheumatoid arthritis, lupus, Crohn’s disease, etc. Many of its adverse effects are known but there are many more adverse effects for which have there is no pathophysiological understanding till date. Haematological adverse effects of methotrexate are not uncommon but symptoms of haematemesis and malaena after 20 days of accidental intake of methotrexate is very very uncommon, especially when patient was only on methotrexate and no other drugs like NSAIDs to precipitate the upper GI-bleed. We hereby report such a case of methotrexate induced haematemesis and malena who came to us for treatment. After immediate administration of essential drugs, there was rapid recovery. The patient was discharged from the hospital symptom free.

Keywords

• Methotrexate
• Haematemesis
• Malaena