A Case of Methotrexate Induced Pneumonitis in a Patient with Rheumatoid Arthritis

Methotrexate is commonly used in rheumatoid arthritis as an anti-inflammatory agent, but treatment with methotrexate can lead to severe side effects, especially pulmonary complication. Interstitial pneumonitis is one of the most important pulmonary adverse effects of methotrexate and most patient present with a subacute febrile illness and peripheral eosinophilia is seen in about a half of patients. Almost all patients have abnormal chest roentgenograms and bibasilar interstitial infiltration with alveolar pulmonary consolidations is the most characteristic finding. Interstitial inflammation with mononuclear cell infiltration is a characteristic pathologic feature and findings that suggest acute hypersensitivity pneumonitis, such as bronchiolitis, granuloma formation with giant cells, and infiltration with eosinophils are often present. Methotrexate-induced pneumonitis is a potentially life threatening and unpredictable complication but it is difficult to make a definite diagnosis in the absence of high index of clinical suspicion. Early recognition and appropriate management may avoid the serious outcome. Herein we report a case of methotrexate-induced pneumonitis in a patient with rheumatoid arthritis.(Tuberc Respir Dis 2004; 57:273-277)

keywords: Methotrexate, Pneumonitis, Rheumatoid arthritis.서류마티스 관절염 환자에서 Methotrexate에 의해 발생한 간질성 폐렴 1예가톨릭대학교 의과대학 내과학교실박찬석, 이상학, 심건호, 김완욱, 이숙영, 김석찬, 김관형, 문화식, 송정섭, 박성학A Case of Methotrexate Induced Pneumonitis in a Patient withRheumatoid ArthritisChan Seok P, Methotrexate, Pneumonitis, Rheumatoid arthritis.서류마티스 관절염 환자에서 Methotrexate에 의해 발생한 간질성 폐렴 1예가톨릭대학교 의과대학 내과학교실박찬석, 이상학, 심건호, 김완욱, 이숙영, 김석찬, 김관형, 문화식, 송정섭, 박성학A Case of Methotrexate Induced Pneumonitis in a Patient withRheumatoid ArthritisChan Seok P

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Article Contents

Vol.57 No.3

A Case of Methotrexate Induced Pneumonitis in a Patient with Rheumatoid Arthritis

Abstract

Reference

Tuberculosis & Respiratory Diseases