Successful treatment of leflunomide-induced acute pneumonitis with cholestyramine wash-out therapy.
Drug-induced acute pneumonitis is a rare but potentially fatal adverse drug reaction. A high index of suspicion is needed for early diagnosis as it mimics community acquired pneumonia and interstitial lung disease that can occur in rheumatoid arthritis. We report a 32-year-old Chinese lady who suffered from leflunomide-induced pneumonitis and improved dramatically after receiving cholestyramine wash-out therapy. This case illustrates the need for clinical alertness to this potentially fatal complication. When in doubt, discontinuation of leflunomide and empirical wash-out therapy should be administered without delay.
Wong
S P Y
SP
Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China.
Chu
C M
CM
Kan
C H
CH
Tsui
H S
HS
Ng
W L
WL
D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000188:drug therapy*; D000837:Anion Exchange Resins / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002792:Cholestyramine Resin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000188:drug therapy
D000837:Anion Exchange Resins; D018501:Antirheumatic Agents; D007555:Isoxazoles; D002792:Cholestyramine Resin; D000077339:Leflunomide