Pneumocystis carinii pneumonia associated with methotrexate therapy in rheumatoid arthritis.
Opportunistic infections occur in patients with rheumatic diseases treated with low dose methotrexate (MTX) with or without other immunosuppressants. Our case report illustrates a fatal case of Pneumocystis carinii pneumonia in a patient with rheumatoid arthritis treated with low dose MTX and glucocorticoid. A review of the literature reveals other opportunistic infections such as Cryptococcus, Nocardia, and herpes zoster presenting in such patients. These occurrences suggest that MTX should be used cautiously in patients with rheumatic disease receiving concomitant medical therapy.
Flood
D A
DA
Department of Medicine, Wellesley and Princess Margaret Hospitals, University of Toronto, ON, Canada.
Chan
C K
CK
Pruzanski
W
W
D000293:Adolescent; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000139:chemically induced / Q000209:etiology; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced* / Q000209:etiology
D005938:Glucocorticoids; D008727:Methotrexate