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Methotrexate-induced diffuse interstitial pulmonary fibrosis.

C W Bedrossian, W C Miller, M A Luna

    Southern Medical Journal
    |March 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

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    Methotrexate can cause severe lung disease, leading to fatal respiratory failure. This study highlights a distinct form of methotrexate pneumonitis presenting as diffuse interstitial pulmonary fibrosis.

    Area of Science:

    • Pulmonary Medicine
    • Toxicology
    • Oncology

    Background:

    • Methotrexate is a widely used chemotherapy agent and immunosuppressant.
    • Methotrexate-induced lung disease is a known, albeit uncommon, adverse effect.
    • Previous reports often described methotrexate pneumonitis with eosinophilia or granulomas.

    Observation:

    • Three patients receiving methotrexate developed bilateral pulmonary infiltrates.
    • These patients lacked peripheral blood eosinophilia.
    • Sputum cultures and stains did not identify infectious or opportunistic organisms.

    Findings:

    • Autopsies revealed diffuse interstitial pulmonary fibrosis, similar to Hamman-Rich syndrome.
    • Pulmonary eosinophilia and granulomas, typically associated with methotrexate pneumonitis, were absent.

    Related Experiment Videos

  • Methotrexate hepatotoxicity was noted in one patient.

    • Implications:

    • Methotrexate should be recognized as a potential cause of diffuse interstitial pulmonary fibrosis.
    • Diffuse interstitial pulmonary fibrosis must be considered in the differential diagnosis of methotrexate recipients with pulmonary infiltrates.
    • This distinct presentation of methotrexate pneumonitis expands the understanding of its pulmonary toxicity.