Methotrexate Pneumonitis in Rheumatoid Arthritis–a Dramatic Response to Treatment

Mulherin, D.; Cummiskey, Joseph; Doyle, Gerard; FitzGerald, Oliver

doi:10.1093/rheumatology/31.5.356

Cited by 13 publications

(8 citation statements)

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“…Both the combined study population of clinical cases and the lung biopsy tissue obtained for histopathologic analysis represent the largest cohort reported in the medical literature for the study of MTX lung toxicity. In addition, in the present study, we combined the uniform requirements for clinical data collection and (12) 316 (50) 116 (1 7) 216 (33) * Total number of patients for whom data were available.…”

Section: Discussionmentioning

confidence: 99%

Clinical, laboratory, radiographic, and histopathologic features of methotrexate‐associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature review

Kremer

Alarcón

Weinblatt

et al. 1997

Arthritis & Rheumatism

282

166

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Objective. To describe the clinical, laboratory, radiologic, and histopathologic features of methotrexate (MTX)-induced lung injury in a combined cohort of selected patients with rheumatoid arthritis (RA) and all cases reported in the English-language literature.Methods. Retrospective combined cohort review and abstraction from the medical literature. Case reports were obtained from 6 centers that had 4 or more cases of potential MTX lung injury per site. RA patients who were seen between 1981 and 1993 and who satisfied predetermined criteria for the presence of MTX lung injury were identified.Results. Twenty-seven patients satisfied the criteria for definite MTX lung injury, and 2 for probable MTX lung injury. Predominant clinical features of MTX lung injury included shortness of breath in 27 patients (93.1%), which was present for 23.5 f 22.3 days

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Section: Discussionmentioning

confidence: 99%

Clinical, laboratory, radiographic, and histopathologic features of methotrexate‐associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature review

Kremer

Alarcón

Weinblatt

et al. 1997

Arthritis & Rheumatism

282

166

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“…These comprised 47 (38.2%) males and 76 (61.8%) females of mean age 49.3 yrs (range 3–79 yrs). The lung was examined histologically in 49 cases [8, 10, 14, 17–49]: surgical lung biopsy in 22 [8, 10, 14, 17–28], transbronchial lung biopsy in 14 [29–40] and percutaneous lung biopsy in one [41]. Post mortem histological examination was carried out in 15 [25, 26, 29, 30, 42–48], four of whom had undergone previous lung biopsy [25, 26, 29, 30].…”

Section: Methodsmentioning

confidence: 99%

Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients

Imokawa¹,

Colby²,

Leslie³

et al. 2000

Eur Respir J

327

188

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Pneumonitis is a serious and unpredictable side-effect of treatment with methotrexate (MTX) that may become life-threatening. The clinical and histological features of nine cases of MTX pneumonitis are reported and the literature reviewed.The typical clinical symptoms include progressive shortness of breath and cough, often associated with fever. Hypoxaemia and tachypnoea are always present and crackles are frequently audible. Chest radiography reveals a diffuse interstitial or mixed interstitial and alveolar infiltrate, with a predilection for the lower lung fields. Pulmonary function tests show a restrictive pattern with diminished diffusion capacity. Lung biopsy reveals cellular interstitial infiltrates, granulomas or a diffuse alveolar damage pattern accompanied by perivascular inflammation. These clinical and pathological findings are not specific to MTX pneumonitis and can be seen with other drug-induced lung toxicities.It is important that all patients receiving methotrexate be educated concerning this potential adverse reaction and instructed to contact their physicians should significant new pulmonary symptoms develop while undergoing therapy. If methotrexate pneumonitis is suspected, methotrexate should be discontinued, supportive measures instituted and careful examination for different causes of respiratory distress conducted. Eur Respir J 2000; 15: 373±381.

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“…[109][110][111][112][113][114][115][116] Methotrexate is a teratogen and should be avoided in pregnancy. Methotrexate therapy should be followed with a complete blood count (CBC) and LFTs every 4 to 8 weeks.…”

Section: Efficacy/safety Of Immunomodulatory Therapy In Uveitismentioning

confidence: 99%

Immunomodulatory Medications in Uveitis

Vavvas¹,

Foster²

2004

International Ophthalmology Clinics

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Methotrexate Pneumonitis in Rheumatoid Arthritis–a Dramatic Response to Treatment

Cited by 13 publications

References 0 publications

Clinical, laboratory, radiographic, and histopathologic features of methotrexate‐associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature review

Clinical, laboratory, radiographic, and histopathologic features of methotrexate‐associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature review

Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients

Immunomodulatory Medications in Uveitis

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