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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Kidney Infection And Abnormal Liver Function Causing Severe Pain?

Taking methotrexate for rheumatiod arthritis (diagnosed Sept 2014) . Felt ill 8 days ago. Had v heavy menstrual bleeding (period not due) and very bad stomach/abdiminal pain. Tested for pregnancy - negative as expected. Blood tests Tuesday showed kidney infection and liver function (LFT) abnormal. Given various antibiotics (Co amoxiclav then doxycyclone, metronidazole), norethisterone for bleeding and codeine phosphate for pain. Been sick every time I try to eat since last Tuesday. RA hospital not answering my messages and GP doesn t seem to know what to do. On call doc is no help. Is this a reaction/side effect of methotrexate? Codeine not eradicating the pain.
Mon, 20 Apr 2015
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Diabetologist,  's  Response
Hi,
After going through your case there is likely possibility of
1) methotrexate side effects like derangement in liver function and effect on blood cells (white blood cells and platelets).
Deranged Liver function may associated with coagulation dysfunction and low platelets may be the cause for heavy bleeding.
Decreased white blood cells associated with increased chances of infection.
2) part of rheumatoid arthritis.

I will advise you -
1) Consultant rheumatologist immediately.
2) Blood tests like complete blood count, kidney function tests, coagulation profile (liver function test already done)
3) Urine test including urine culture and sensitivity.
4) Ultrasonography of abdomen for liver and kidneys.


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What Causes Kidney Infection And Abnormal Liver Function Causing Severe Pain?

Hi, After going through your case there is likely possibility of 1) methotrexate side effects like derangement in liver function and effect on blood cells (white blood cells and platelets). Deranged Liver function may associated with coagulation dysfunction and low platelets may be the cause for heavy bleeding. Decreased white blood cells associated with increased chances of infection. 2) part of rheumatoid arthritis. I will advise you - 1) Consultant rheumatologist immediately. 2) Blood tests like complete blood count, kidney function tests, coagulation profile (liver function test already done) 3) Urine test including urine culture and sensitivity. 4) Ultrasonography of abdomen for liver and kidneys.