Pneumocystis carinii pneumonia complicating methotrexate treatment of primary sclerosing cholangitis.
The etiology of primary sclerosing cholangitis, a chronic progressive cholestatic liver disease, is poorly understood. Treatment with oral methotrexate may improve patient symptoms, liver biochemistry, and hepatic histology. This report describes a severe life-threatening complication of methotrexate therapy in primary sclerosing cholangitis--the development of Pneumocystis carinii pneumonia. The reported cases of methotrexate-associated P. carinii pneumonia in the literature are reviewed. With the increasing use of methotrexate in chronic inflammatory disorders, physicians should be aware of this potentially lethal complication.
Duerksen
D R
DR
Department of Medicine, University of Alberta, Edmonton, Canada.
Blondel-Hill
E
E
Bailey
R J
RJ
D000328:Adult; D015209:Cholangitis, Sclerosing / Q000188:drug therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000209:etiology; D011020:Pneumonia, Pneumocystis / Q000209:etiology* / Q000276:immunology
D007166:Immunosuppressive Agents; D008727:Methotrexate