severe multisystem toxicity of 8-day methotrexate/folinic acid regimen in the manage-ment of low-risk gestational trophoblastic neoplasia: a case report

Methotrexate (mtx) is routinely used in safe regimens to manage low-risk gestational tropho-blastic neoplasia. the most common complications reported in this application include bone mar-row suppression, mucositis, nausea and vomiting, neuropathy, and change in the hepatic and re-nal function, however, it is not usual for generalized maculopapular rash as well as organ dys-function during the first courses of 8 days mtx/folinic acid chemotherapy regimens in a low risk gestational trophoblastic neoplasia young patient, who hasn’t a history of immune dysfunction or drug interaction. so, we report a case of acute severe multi-system mtx toxicity with a danger-ous cutaneous reaction that has been reported previously in the chronic use of mtx in psoriasis patients, thus to aid physicians in better realizing the mtx toxicity, we emphasized the im-portance of early diagnosis and appropriate management of unexpected reaction in a young pa-tient that wasn’t susceptible for such a severe toxicity.