Re: GYN: Mouse antibodies/HCG
From: art fougner, md (evsono@pipeline.com)
Thu Jul 29 06:56:31 2004
Garry
have seen 5 cases of MTX administered for the treatment of ectopic in
which an apparently normally developing fetus, heartbeat and all, was
visualized subsequent to the injection. your caution is justified.
art
At Wed, 28 Jul 2004, Garry E. Siegel, M.D. wrote:
>
>One more thing--I've seen a few case reports (malpractice ones) about
>giving chemo with an incorrect diagnosis of a trophoblastic tumor. While
>it wasn't a simple shot of methotrexate, I'm not ready to administer
>until this is fully investigated.
>
>Garry
>
>Robert:
>
>No doubt an abnormal pregnancy IF a pregnancy.
>
>I spoke with local hospital lab tech last night--she was familiar with
>this and suggests a UCG.
>
>This AM, UCG negative (HCG was 150 2 days ago, stable for 3 weeks).
>
>Hospital #1 lab guy suggests using their HCG machine--methodology to
>reduce cross reactivity. Hospital #2 lab girl says the same on their
>machine.
>
>Reference lab guy called and hasn't a clue, but the medical director is
>to call. Their catalog of tests offers a mouse antibody test.
>
>Once I hear from the lab doc, I'll likely send off the mouse test AND a
>hospital HCG.
>
>Garry
>
>At Wed, 28 Jul 2004, RModugno@aol.com wrote:
>>
>>In a message dated 7/27/2004 6:07:01 PM Eastern Standard Time,
>>garrys@mindspring.com writes:
>>I have inherited a case to deal with while my partner is on vacation;
>>details sketchy.
>>
>>32 YO P0 with positive UCG 7/8 in office, 7/8 spotted, HCG 150 approx.,
>>progesterone 1.7. Had "menses" for a few days, and now is not bleeding,
>>asymptomatic, and still is running HCGs around 144 to 150 (all in the
>>same lab).
>>
>>While I don't know this for sure, I have no doubt that she has been
>>examined and it was benign. Ultrasound 7/23--empty uterus, normal
>>adnexa, trace free fluid.
>>
>>Is this a case where mouse antibodies might help?
>>Use a different lab (waiting to talk to the lab supervisor in one
>>hospital about this)?
>>Could this be a chronic ectopic?
>>Should I empty her uterus and go from there?
>>
>>The lab tech today (after 5 PM)at the hospital immediately suggested
>>doing a urine pregnancy test, and that is planned tomorrow. However, I
>>didn't realize that she had been positive in the UCG on 7/8.
>>
>>Any thoughts?
>>
>>Garry
>>Abnormal pregnancy. A shot of methotrexate couldn't hoit!
>>Emptying an 'empty" uterus will complicate things and if it's empty - then
>>what?
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, GA
>>http://www.novaobgyn.yourmd.com
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
art fougner, md
ich bin ein New Yorker
|
|
