Pulmonary function in children with juvenile idiopathic arthritis and effects of methotrexate therapy.
OBJECTIVE
To evaluate impairment of lung function as an adverse effect associated with methotrexate therapy in patients with juvenile idiopathic arthritis (JIA).


METHODS
We performed pulmonary function testing including diffusion capacity for carbon monoxide as measured by the single breath method (DLCO-SB) in 89 children with juvenile idiopathic arthritis. Forty (45%) were treated with methotrexate for a median of 24 months (range 3 to 120 months). Except for the presence of asthma in two children, there was no clinical or radiological evidence of pulmonary disease.


RESULTS
Pulmonary function testing demonstrated moderate airway obstruction in two children with known bronchial asthma. Neither obstructive nor restrictive alteration of ventilation was found in any other patient. Two juvenile idiopathic arthritis patients showed a reduced CO diffusion capacity of 64 and 67%. One of them was treated with methotrexate.


CONCLUSIONS
With regard to lung function impairment treatment with low dose methotrexate appears to be safe even when performed for several years reaching a total amount of up to 3.5 g. In contrast to studies performed in adult rheumatoid arthritis patients, in children with juvenile idiopathic arthritis impairment of lung function is a rare event.
Schmeling
H
H
Department of Paediatrics, Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany.
Stephan
V
V
Burdach
S
S
Horneff
G
G
D000293:Adolescent; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008176:Lung Volume Measurements; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D010993:Plethysmography, Whole Body; D011653:Pulmonary Diffusing Capacity / Q000187:drug effects; D012129:Respiratory Function Tests
D018501:Antirheumatic Agents; D008727:Methotrexate