1991
DOI: 10.1136/ard.50.1.67-b
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Cytomegalovirus pneumonia in a patient with rheumatoid arthritis treated with low dose methotrexate and prednisone.

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Cited by 30 publications
(13 citation statements)
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“…P carinii pneumonia has been reported in association with methotrexate treatment in persons with RA (21,28,32-37), psoriatic arthritis (22), asthma (26), and malignancies treated with chemotherapy and/or transplantation (46). Other infections reported in RA patients receiving methotrexate include cryptococcosis (38), nocardiosis (23,24,27), herpes zoster (25,33), Listeria meningitis (28), herpes simplex hepatitis (29), cytomegalovirus pneumonia (30), and disseminated histoplasmosis (24).…”
Section: Discussionmentioning
confidence: 99%
“…P carinii pneumonia has been reported in association with methotrexate treatment in persons with RA (21,28,32-37), psoriatic arthritis (22), asthma (26), and malignancies treated with chemotherapy and/or transplantation (46). Other infections reported in RA patients receiving methotrexate include cryptococcosis (38), nocardiosis (23,24,27), herpes zoster (25,33), Listeria meningitis (28), herpes simplex hepatitis (29), cytomegalovirus pneumonia (30), and disseminated histoplasmosis (24).…”
Section: Discussionmentioning
confidence: 99%
“…a Chest radiographs revealed bilateral ground-glass infiltrates and reticular shadows. b The shadows disappeared after treatment with prednisolone and trimethopurim/ sulfamethoxazole a b MTX is effective for RA are still unclear, many antiinflammatory and immunosuppressive actions, such as the inhibition of cellular proliferation, alterations in the lymphocyte subsets, a decreased cytokine production, the suppression of T-cell activation, and cell adhesion molecules, [1][2][3][4][5][6][7][8][9][10][11][12] have all been hypothesized to play a role. The concomitant use of nonsteroidal anti-inflammatory drugs, which can raise the plasma concentration of MTX by displacing it from albumin binding sites and impairing its renal excretion, could also have potentiated the MTX toxicity.…”
Section: Discussionmentioning
confidence: 99%
“…CMV pneumonia can occur even with low-dose MTX therapy (7). A CMV patient with ileitis taking prednisolone 60 mg daily for 1 month for systemic lupus erythematosus (8) and a CMV patient with colitis treated with prednisolone 10 to 30 mg daily for 2 years for systemic lupus erythematosus (9) were reported, suggesting that single corticosteroid therapy for connective tissue diseases can precipitate CMV re-activation, although the critical dose or duration of corticosteroid therapy that triggers the development of CMV reactivation remains unknown.…”
Section: Discussionmentioning
confidence: 99%