This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (106)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

E. William St Clair, MD; John R. Rice, MD; Ralph Snyderman, MD

Arch Intern Med. 1985;145(11):2035-2038.

Abstract
• Three of 95 patients with rheumatoid arthritis who were being treated with low-dose (5 to 15 mg/wk) methotrexate sodium developed the clinical, radiographic, and pathologic features of methotrexate-associated pulmonary injury. Marked hypoxemia emphasized the severity of illness in our patients; lowest oxygen pressure values for each patient were 35 mm Hg, 42 mm Hg, and 45 mm Hg. The management of our patients with a pulmonary toxic reaction to methotrexate included discontinuing the drug treatment, antibiotic therapy until an infectious cause was excluded, and high-dose methylprednisolone. Two patients recovered and one died. Contrary to an earlier report that suggested that pneumonitis occurred only with methotrexate sodium doses exceeding 15 mg/wk, our three cases demonstrate that a severe pulmonary toxic reaction may also complicate low-dose weekly methotrexate therapy of rheumatoid arthritis.

(Arch Intern Med 1985;145:2035-2038)

Author Affiliations
From the Division of Rheumatology and Immunology, Department of Medicine, Duke University Medical Center, Durham, NC.

Footnotes
Accepted for publication Feb 5, 1985.

Read in part before the annual scientific meeting of the American Rheumatism Association, Minneapolis, June 7, 1984.

Reprint requests to PO Box 3874, Duke University Medical Center, Durham, NC 27710 (Dr St Clair).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Variation of immunological response in methotrexate-induced pneumonitis
Chikura et al.
Rheumatology (Oxford) 2008;47:1647-1650.
ABSTRACT | FULL TEXT  

Lethal pneumonitis under leflunomide therapy
Vallbracht et al.
Rheumatology (Oxford) 2005;44:1580-1581.
FULL TEXT  

Long-Term Complications of Antineoplastic Agents
Davis
Journal of Pharmacy Practice 1991;4:131-150.
 

Methotrexate in Rheumatoid Arthritis: Indications, Contraindications, Efficacy, and Safety
TUGWELL et al.
ANN INTERN MED 1987;107:358-366.
ABSTRACT  

Methotrexate-Induced Pneumonitis: Diagnostic Value of Bronchoalveolar Lavage Cell Data
Akoun et al.
Arch Intern Med 1986;146:804-805.
ABSTRACT  

Pneumonitis During Low-Dose Methotrexate Therapy
Maier et al.
Arch Intern Med 1986;146:602-603.
ABSTRACT