1/3. Serosal complications of single-agent low-dose methotrexate used in gestational trophoblastic diseases: first reported case of methotrexate-induced peritonitis.methotrexate (MTX) is a folate antagonist widely used both as an anticancer drug and as an immunosupressant. Administration of an 8-day methotrexate and folinic acid regime may be associated with pleuritic chest pain and pneumonitis. We have reviewed the toxicity seen in 168 consecutive patients treated with low-dose MTX for persistent trophoblastic disease. Twenty-five per cent of patients developed serosal symptoms, pleurisy was the commonest complaint. The majority of patients had mild to moderate symptoms which were controlled with simple analgesia and did not necessitate a change in treatment; 11.9% had severe symptoms which necessitated a change in treatment. One patient developed a pericardial effusion and a second patient developed severe reversible peritoneal irritation. The possible aetiology and pathophysiology of methotrexate-induced serosal toxicity is discussed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/3. Chronic adhesive lupus serositis as a complication of systemic lupus erythematosus. Refractory chest pain and small-bowel obstruction.Serious clinical sequelae of lupus serositis are uncommon and rarely a cause of morbidity. We describe two patients, one with chronic adhesive pericarditis and one with extensive small-bowel adhesions due to lupus peritonitis. In both, delayed institution of adequate prednisone therapy may have played a contributing role.- - - - - - - - - - ranking = 4keywords = chest (Clic here for more details about this article) |
3/3. Taiwanese patient with recurrent polyserositis: report of a case.A 26-year-old man had suffered from recurrent abdominal pain, ascites and arthralgia since childhood. The symptoms occurred usually during the winter, and each attack lasted for two to three days. Initially, the frequency was about once a year, but it had increased to once every one to four months after an exploratory laparotomy carried out four years ago. leukocytosis accompanied each episode. Many laboratory examinations and imaging studies failed to show pathologic lesions. Laparoscopic examination revealed only yellowish ascites with a hyperemic mesentery and omentum. There were never any sequelae after the attacks. After prophylaxis with colchicine 0.6 mg three times a day, no more attacks occurred. familial mediterranean fever (familial paroxysmal polyserositis) was the most likely diagnosis. Recognizing this disease entity in Taiwanese patients may help to avoid unnecessary operations.- - - - - - - - - - ranking = 13.35963652566keywords = abdominal pain (Clic here for more details about this article) |