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Methotrexate pneumonitis in bronchial asthma
1Section of Allergy, Immunology and Rheumatology, Veterans General Hospital-Taipei, Taiwan.
International Archives of Allergy and Immunology
|January 1, 1993
Summary
Methotrexate pneumonitis, a serious side effect of methotrexate therapy, has not been previously reported in bronchial asthma patients. Early withdrawal of methotrexate and corticosteroid treatment resolved the condition in a steroid-dependent asthma patient.
Area of Science:
- Pulmonology
- Rheumatology
- Pharmacology
Background:
- Low-dose pulse methotrexate is used for rheumatoid arthritis and other conditions.
- Methotrexate pneumonitis is a known, serious adverse effect in rheumatoid arthritis patients.
- The occurrence of methotrexate pneumonitis in bronchial asthma patients has not been previously documented.
Observation:
- A patient with steroid-dependent bronchial asthma was treated with intermittent low-dose methotrexate pulse therapy.
- The patient developed symptoms including dyspnea, fever, and oral ulcers within 4 months.
- Severe hypoxemia and bilateral interstitial lung infiltrates were observed.
Findings:
- The patient's lung lesions resolved completely after treatment with corticosteroids and discontinuation of methotrexate.
- This case suggests methotrexate can induce pneumonitis in bronchial asthma patients.
- Methotrexate pneumonitis is a potential adverse effect even in non-rheumatoid arthritis indications.
Implications:
- Clinicians should consider methotrexate pneumonitis in asthma patients presenting with respiratory symptoms during therapy.
- Early recognition and withdrawal of methotrexate, along with corticosteroid treatment, are crucial for managing methotrexate pneumonitis.
- This finding expands the known spectrum of methotrexate-induced pulmonary toxicity.