Leflunomide-Induced Interstitial Lung Disease: A Case Report

Abstract

Leflunomide (LEF) induced interstitial pneumonitis is a very rare condition but potentially fatal. We report a case of LEF induced interstitial pneumonitis. A 63-year-old woman followed-up for 37 years with the diagnosis of rheumatoid arthritis treated with LEF (20 mg/day) since 5 months were admitted to our hospital with cough, dyspnea, fever, and dark sputum.Chest radiography represented bilateral alveolar consolidation. High-resolution computed tomography demonstrated diffuse ground-glass appearance and interlobular septal thickening. Since the patient's clinics and radiologic findings improved dramatically after the cessation of LEF and recieving oral steriod therapy, she was diagnosed as drug-induced interstitial lung disease. In conclusion, when nonspecific clinical signs such as respiratory distress, cough and fever seen during the use of LEF, drug-induced interstitial lung disease should be kept in mind for the differantial diagnosis.

Leflunamide Induced Pneumonitis in Rheumatoid Arthritis - A Case Report and Review of Literature

“…Higher dose (100mg), age, body weight <40 kg male sex, presence of previous lung injury, genetic predosposition, treatment history with MTX are the risk factors for LEIP. 16 In this case, there was di use alveolar consolidation, ground glass densities, and septal thickenings, consistent with the Figure-1(B) Figure -1(A) ndings reported in the literature. Especially discontinuation of LEF and MTX, faster clinical and radiological regression after steroid justi ed the diagnosis of LEIP in this case and plasma exchange could be an alternative method to clear the active metabolites.15…”