A Case of Methotrexate: Associated Interstitial Pneumonitis in Rheumatoid Arthritis.
- Author:
Ji Yeon KIM
;
Wan Uk KIM
;
Sung Il KIM
;
Wan Hee YOO
;
Sung Hwan PARK
;
Yeon Sik HONG
;
Seok Chan KIM
;
Chul Soo CHO
;
Ho Youn KIM
;
Youn Soo LEE
- Publication Type:Case Report
- Keywords:
Methotrexate associated interstitial pneumonitis;
Rheumatoid arthritis;
Corticosteroid therapy126
- MeSH:
Arthritis, Rheumatoid*;
Biopsy;
Coloring Agents;
Glucocorticoids;
Humans;
Hypersensitivity;
Lung;
Lung Diseases, Interstitial*;
Methotrexate*;
Mouth;
Pathology;
Pneumonia;
Rheumatic Diseases
- From:The Journal of the Korean Rheumatism Association
1998;5(1):126-132
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The use of oral methotrexate in a low dose given once weekly has become the mainstay of therapy for active and sustained rheumatoid arthritis. Pneumonitis can be expected to occur in patients taking low doses of methotrexate for rheumatoid arthritis. The pathology suggests that methotrexate pneumonitis is a hypersensitivity reaction although arguments have been put forth that it is idiosyncratic. Treatment of presumed methotrexate pneumonitis, even while waiting for special stains, cultures, or tissue sections from bronchoscopic biopsy, should be glucocorticoids given intravenously or by mouth. Empirical antibiotic treatment can be used until infectious causes are ruled out. In recent years there has been an increase in the number of reports of pulmonary complications associated with low-dose methotrexate therapy for rheumatic diseases. Among these complications interstitial pneumonitis has been most often reported (more than 35 cases since the first report in 1983). We report a case of methotrexateassociated pulmonary complication in rheumatoid arthritis confirmed by transbronchoscopic lung biopsy, which resolved by treatment of corticosteroid therapy.