[Fatal pneumonitis during low-dose methotrexate treatment]
1Institut für Rechtsmedizin, Abteilung Forensische Medizin, Universität Zürich, Winterthurerstr. 190/52, CH-8057, Zürich, Schweiz, viktor.martos@irm.uzh.ch.
Zeitschrift Fur Rheumatologie
|January 31, 2012
Summary
Sudden death occurred in a rheumatoid arthritis patient treated with methotrexate. Autopsy revealed fibrosing alveolitis, highlighting the need for prompt medication cessation if respiratory symptoms arise.
Area of Science:
- Rheumatology
- Pulmonology
- Forensic Pathology
Background:
- Rheumatoid arthritis is a chronic autoimmune disease.
- Methotrexate is a common disease-modifying antirheumatic drug (DMARD).
Observation:
- A 71-year-old woman with rheumatoid arthritis was treated with methotrexate.
- Her arthritis symptoms resolved, but she died suddenly two months later.
- A cumulative dose of 160 mg methotrexate had been administered.
Findings:
- Forensic examination revealed fibrosing alveolitis.
- Methotrexate-induced lung toxicity is a known, albeit rare, complication.
Implications:
- Prompt recognition and cessation of methotrexate are crucial if respiratory symptoms develop.
- Early diagnosis and treatment with corticosteroids may be life-saving.
- This case underscores the importance of monitoring for pulmonary side effects during methotrexate therapy.
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