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Pulmonary Nodules After Leflunomide Therapy in Rheumatoid Arthritis: A Case Report
Mahdiye Abiyarghamsari1,2, Arman Ahmadzadeh3
1Department of Clinical Pharmacy, School of Pharmacy Shahid Beheshti University of Medical Sciences Tehran Iran.
Clinical Case Reports
|December 31, 2024
Summary
Leflunomide therapy for rheumatoid arthritis can cause rare lung complications. Discontinuing the drug led to the resolution of pulmonary nodules in one patient, highlighting the need for monitoring.
Area of Science:
- Rheumatology
- Pulmonology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a systemic autoimmune disease.
- RA can present with articular and extra-articular manifestations.
- Pulmonary complications are rare but serious in RA patients.
Purpose of the Study:
- To report a rare case of pulmonary toxicity secondary to leflunomide in a rheumatoid arthritis patient.
- To emphasize the importance of recognizing drug-induced lung disease.
- To highlight the diagnostic challenges and management of such complications.
Main Methods:
- Case report of a 65-year-old male with long-standing RA.
- Evaluation included exclusion of infectious, neoplastic, and autoimmune etiologies.
- Diagnostic procedures involved bronchoscopy and biopsy.
Main Results:
- The patient developed multiple cavitary pulmonary nodules after prolonged leflunomide treatment.
- Bronchoscopy and biopsy revealed an acute suppurative inflammatory process with central necrosis.
- Discontinuation of leflunomide resulted in the complete resolution of pulmonary nodules.
Conclusions:
- Leflunomide can induce pulmonary complications in rheumatoid arthritis patients.
- Prompt recognition and management of drug-induced pulmonary toxicity are crucial.
- Vigilance for potential leflunomide-related lung issues is essential in RA management.
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