title: Neurological and pulmonary adverse effects of subcutaneous methotrexate therapy.
abstract: We report the case of a patient receiving subcutaneous methotrexate (MTX) treatment for rheumatoid arthritis (RA) who developed a complex pattern of neurological and pulmonary symptoms. Fluctuant dysarthria, magnetic gait, weakness and dysmetria of the lower limbs, as well as symptoms and signs consistent with a diagnosis of pneumonitis started within 6 weeks of initiating MTX treatment and slowly resolved after its discontinuation. This case highlights the fact that even the relatively low doses of MTX in the therapy of RA can produce neurotoxicity, which can become manifest in a broad range of symptoms.
authors.affiliation: Department of Clinical Radiology, University of Munich, Grosshadern Campus, Germany. wieland.sommer@med.uni-muenchen.de
authors.forename: W H
authors.initials: WH
authors.lastname: Sommer
authors.forename: V
authors.initials: V
authors.lastname: Ganiere
authors.forename: D
authors.initials: D
authors.lastname: Gachoud
authors.forename: A
authors.initials: A
authors.lastname: Keta
authors.forename: A
authors.initials: A
authors.lastname: Abou-Hajar
authors.forename: J
authors.initials: J
authors.lastname: Dudler
authors.forename: D
authors.initials: D
authors.lastname: Aujesky
mesh_terms: D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D011014:Pneumonia / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents; D008727:Methotrexate