Leflunomide-induced polymyositis in a patient with rheumatoid arthritis.
Although rheumatoid arthritis (RA) and myositis are major autoimmune diseases, co-occurrence of the two is rare. We treated a patient who developed polymyositis (PM) following the treatment of RA with leflunomide. Prednisolone (PSL) in combination with methotrexate (MTX) was effective in managing the PM, but the RA relapsed during the treatment. Based on the clinical course, we suspect that the PM was induced by the leflunomide treatment and suggest that clinicians should consider the possibility of this rare adverse event in cases of cholestyramine-resistant elevation of transaminases.
Ochi
Sae
S
Department of Rheumatology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kohtohbashi, Sumida-ku, Tokyo 130-8575, Japan. ochisae@bokutoh-hp.metro.tokyo.jp
Taniguchi
Ken
K
Nagashima
Masakazu
M
D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000410:Alanine Transaminase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D001219:Aspartate Aminotransferases / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology; D017285:Polymyositis / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D011239:Prednisolone; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000077339:Leflunomide; D008727:Methotrexate