Invasive pulmonary aspergillosis associated with low dose methotrexate therapy for rheumatoid arthritis: a case report of treatment with itraconazole.
Opportunistic infections complicating low dose methotrexate therapy are rare, consisting predominantly of Pneumocystis carinii pneumonia. We report a case of invasive pulmonary aspergillosis which developed in a patient being treated for seropositive rheumatoid arthritis with low dose methotrexate (5-7.5 mg weekly) for 8 years. The patient was successfully treated with itraconazole 200 mg daily for 6 months. This case adds to the growing evidence implicating low dose methotrexate with opportunistic infections and should heighten clinical awareness in patients on this treatment.
St. James's Hospital, Dublin, Ireland.
S
S
O'Reilly
P
P
Hartley
M
M
Jeffers
E
E
Casey
L
L
Clancy
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001228:Aspergillosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008168:Lung / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology
D017964:Itraconazole; D008727:Methotrexate