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. 1988 Sep;47(9):784–788. doi: 10.1136/ard.47.9.784

Life threatening acute pneumonitis during low dose methotrexate treatment for rheumatoid arthritis: a case report and review of the literature.

M G Ridley 1, C S Wolfe 1, J A Mathews 1
PMCID: PMC1003598  PMID: 3052323

Abstract

A patient is described with definite rheumatoid arthritis (RA) who developed life threatening acute pneumonitis after receiving a total dose of only 12.5 mg methotrexate (MTX). This complication has been previously described, but this is probably the lowest reported dose before development of pneumonitis in a patient with RA. The possible significance of this case is discussed in the light of recent reports suggesting an increased susceptibility of patients with RA to the pulmonary toxicity of MTX.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson L. L., Collins G. J., Ojima Y., Sullivan R. D. A study of the distribution of methotrexate in human tissues and tumors. Cancer Res. 1970 May;30(5):1344–1348. [PubMed] [Google Scholar]
  2. Cannon G. W., Ward J. R., Clegg D. O., Samuelson C. O., Jr, Abbott T. M. Acute lung disease associated with low-dose pulse methotrexate therapy in patients with rheumatoid arthritis. Arthritis Rheum. 1983 Oct;26(10):1269–1274. doi: 10.1002/art.1780261015. [DOI] [PubMed] [Google Scholar]
  3. Carson C. W., Cannon G. W., Egger M. J., Ward J. R., Clegg D. O. Pulmonary disease during the treatment of rheumatoid arthritis with low dose pulse methotrexate. Semin Arthritis Rheum. 1987 Feb;16(3):186–195. doi: 10.1016/0049-0172(87)90021-7. [DOI] [PubMed] [Google Scholar]
  4. Clarysse A. M., Cathey W. J., Cartwright G. E., Wintrobe M. M. Pulmonary disease complicating intermittent therapy with methotrexate. JAMA. 1969 Sep 22;209(12):1861–1868. [PubMed] [Google Scholar]
  5. Daly H., Boyle J., Roberts C., Scott G. Interaction between methotrexate and non-steroidal anti-inflammatory drugs. Lancet. 1986 Mar 8;1(8480):557–557. doi: 10.1016/s0140-6736(86)90910-4. [DOI] [PubMed] [Google Scholar]
  6. Engelbrecht J. A., Calhoon S. L., Scherrer J. J. Methotrexate pneumonitis after low-dose therapy for rheumatoid arthritis. Arthritis Rheum. 1983 Oct;26(10):1275–1278. doi: 10.1002/art.1780261016. [DOI] [PubMed] [Google Scholar]
  7. Everts C. S., Westcott J. L., Bragg D. G. Methotrexate therapy and pulmonary disease. Radiology. 1973 Jun;107(3):539–543. doi: 10.1148/107.3.539. [DOI] [PubMed] [Google Scholar]
  8. From E. Methotrexate pneumonitis in a psoriatic. Br J Dermatol. 1975 Jul;93(1):107–110. doi: 10.1111/j.1365-2133.1975.tb06485.x. [DOI] [PubMed] [Google Scholar]
  9. Goldman G. C., Moschella S. L. Severe pneumonitis occurring during methotrexate therapy. Re- port of two cases. Arch Dermatol. 1971 Feb;103(2):194–197. [PubMed] [Google Scholar]
  11. Panayi G. S., Wooley P., Batchelor J. R. Genetic basis of rheumatoid disease: HLA antigens, disease manifestations, and toxic reactions to drugs. Br Med J. 1978 Nov 11;2(6148):1326–1328. doi: 10.1136/bmj.2.6148.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Shiel W. C., Jr, Prete P. E. Pleuropulmonary manifestations of rheumatoid arthritis. Semin Arthritis Rheum. 1984 Feb;13(3):235–243. doi: 10.1016/0049-0172(84)90027-1. [DOI] [PubMed] [Google Scholar]
  13. St Clair E. W., Rice J. R., Snyderman R. Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis. Arch Intern Med. 1985 Nov;145(11):2035–2038. doi: 10.1001/archinte.145.11.2035. [DOI] [PubMed] [Google Scholar]
  14. Thompson R. N., Watts C., Edelman J., Esdaile J., Russell A. S. A controlled two-centre trial of parenteral methotrexate therapy for refractory rheumatoid arthritis. J Rheumatol. 1984 Dec;11(6):760–763. [PubMed] [Google Scholar]
  15. Weinblatt M. E., Coblyn J. S., Fox D. A., Fraser P. A., Holdsworth D. E., Glass D. N., Trentham D. E. Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med. 1985 Mar 28;312(13):818–822. doi: 10.1056/NEJM198503283121303. [DOI] [PubMed] [Google Scholar]
  16. Williams H. J., Willkens R. F., Samuelson C. O., Jr, Alarcón G. S., Guttadauria M., Yarboro C., Polisson R. P., Weiner S. R., Luggen M. E., Billingsley L. M. Comparison of low-dose oral pulse methotrexate and placebo in the treatment of rheumatoid arthritis. A controlled clinical trial. Arthritis Rheum. 1985 Jul;28(7):721–730. doi: 10.1002/art.1780280702. [DOI] [PubMed] [Google Scholar]

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