title: Pneumocystis jiroveci pneumonia associated with low-dose methotrexate treatment for rheumatoid arthritis: report of two cases and review of the literature.
abstract: Low-dose methotrexate (MTX) therapy is widely used for rheumatoid arthritis (RA) because of its favorable efficacy and toxicity profile. Although Pneumocystis jiroveci pneumonia (PCP) is most often seen in severely immunosuppressed patients, PCP complicating low-dose MTX therapy for RA has been reported to sometimes occur. We herein report two cases of patients who developed PCP during treatment with low-dose MTX, and discuss the importance of prophylaxis for this opportunistic infection.
authors.affiliation: Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. ykaneko@sc.itc.keio.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Akira
authors.initials: A
authors.lastname: Suwa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Michito
authors.initials: M
authors.lastname: Hirakata
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000382:microbiology; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced* / Q000517:prevention & control
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate