Methotrexate
- PDF / 151,338 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 12 Downloads / 195 Views
1 S
Interstitial lung disease secondary to drug toxicity: case report A 52-year-old man developed interstitial lung diseases (ILD) secondary to drug toxicity of methotrexate for rheumatoid arthritis. The man had been diagnosed with rheumatoid arthritis in 2009, at the age of 43 years. Therefore, he had been receiving oral methotrexate 17.5mg every week along with folic-acid, hydroxychloroquine, leflunomide and prednisolone. He was doing well until January 2017; however, he developed progressive dyspnoea along with dry cough. Subsequently, chest examination showed bilateral infra-scapular inspiratory crepitations, and high-resolution CT (HRCT) scan of the lung revealed coarse reticular opacities and areas of consolidation, suggestive of ILD. He was diagnosed with ILD secondary to methotrexate toxicity. Therefore, methotrexate was stopped. The man was treated with azathioprine, and the dose of prednisolone was increased. However, he developed intense thigh muscles pain. Subsequently, he developed severe respiratory distress and required admission into the ICU. His oxygen saturation was 78% on room air and repeated HRCT of the lung demonstrate extensive areas of ground glass veiling and opacification together with interstitial subpleural infiltrates. Subsequently, he developed acute respiratory failure due to exacerbation of ILD. Therefore, he was put on mechanical ventilation, and started receiving treatment with unspecified steroids, antibiotics and other supportive measures. Eventually, his condition improved and he was discharged from the hospital with a high dose of unspecified steroids and azathioprine. Emad Y, et al. Antisynthetase syndrome complicating the course of established case with rheumatoid arthritis: A rare and under-recognized overlapping disease. Reumatologia 803518446 Clinica 16: 419-422, No. 5, Part 2, Sep-Oct 2020. Available from: URL: http://doi.org/10.1016/j.reuma.2018.06.002
0114-9954/20/1833-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 5 Dec 2020 No. 1833
Data Loading...
