title: [Fatal outcome of pneumocystis-carinii pneumonia under low-dose methotrexate and prednisone therapy for chronic rheumatoid arthritis. Case report and literature review].
abstract: New therapeutic schemes have been proposed recently for treatment of rheumatoid arthritis. Among these, methotrexate at low doses is recommended as basic therapy, already shortly after the diagnosis is established. We report on a 68-year-old female with rheumatoid arthritis who developed bilateral pneumocystis-carinii pneumonia with a lethal course and bilateral sinusitis maxillaris with candida lusitaniae. Various opportunistic infections have been described in the literature after low-dose methotrexate. It is our view that the use of methotrexate in rheumatoid arthritis should still be considered cautiously until further data on the risk-benefit ratio of long-term use become available.
authors.affiliation: Medizinische Klinik, Kantonsspital Chur.
authors.forename: E
authors.initials: E
authors.lastname: Wyss
authors.forename: M
authors.initials: M
authors.lastname: Kuhn
authors.forename: H P
authors.initials: HP
authors.lastname: Luzi
authors.forename: W H
authors.initials: WH
authors.lastname: Reinhart
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015523:Maxillary Sinusitis / Q000150:complications / Q000382:microbiology; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents; D011241:Prednisone; D008727:Methotrexate
vernacular_title: Fatal verlaufende Pneumocystis-carinii-Pneumonie unter Low-dose-Methotrexat- und Prednison-Therapie wegen chronischer Polyarthritis. Fallbericht und Literaturübersicht.