title: Methotrexate-induced pulmonary toxicity in psoriatic arthritis (PsA): case presentation and literature review.
abstract: A 45-year-old female with a 4-week history of psoriatic arthritis developed cough, fever, and progressive shortness of breath 2 weeks following initiation of methotrexate therapy. High resolution CT of chest revealed bilateral basal interstitial involvement and diffuse ground glass opacities. Patient, though, died despite immediate discontinuation of methotrexate and initiation of treatment with IV methylprednisolone and cyclophosphamide. Post-mortem examination showed diffuse interstitial pulmonary fibrosis. Methotrexate-induced pulmonary toxicity is a serious event, unpredictable, and unusual, especially in patients with psoriatic arthritis, and although reversible, it may be fatal.
authors: Rheumatology Unit, Faculty of Medicine, National University of Colombia, Bogota, Colombia.
authors: Federico
authors: F
authors: Rondon
authors: Odilio
authors: O
authors: Mendez
authors: Nestor
authors: N
authors: Spinel
authors: Carlos
authors: C
authors: Ochoa
authors: Cristian
authors: C
authors: Saavedra
authors: Edgar
authors: E
authors: Penaranda
authors: Ignacio
authors: I
authors: Garcia-Valladares
authors: Luis R
authors: LR
authors: Espinoza
authors: Antonio
authors: A
authors: Iglesias-Gamarra
references: Rheum Dis Clin North Am. 1997 Nov;23(4):917-37
references: 9361161
references: Reumatismo. 2006 Oct-Dec;58(4):261-7
references: 17216014
references: Mod Rheumatol. 2010 Jun;20(3):280-6
references: 20217173
references: Semin Arthritis Rheum. 1998 Apr;27(5):277-92
references: 9572710
references: JAMA. 1964 Sep 7;189:743-7
references: 14174051
references: Arthritis Rheum. 1983 Oct;26(10):1275-8
references: 6626286
references: Ann Rheum Dis. 2010 Jun;69(6):1044-8
references: 19581281
references: J Thorac Imaging. 2003 Oct;18(4):231-6
references: 14561908
references: Am J Respir Crit Care Med. 1994 Jul;150(1):258-60
references: 8025760
references: Dtsch Med Wochenschr. 1995 Apr 28;120(17):603-8
references: 7736958
references: Semin Arthritis Rheum. 1987 Feb;16(3):186-95
references: 3823910
references: J Rheumatol. 1987 Dec;14(6):1164-71
references: 3325643
references: Ann Intern Med. 1997 Sep 1;127(5):356-64
references: 9273826
references: Toxicology. 2009 Feb 27;256(3):183-90
references: 19100307
references: Clin Rheumatol. 2011 Feb;30(2):217-21
references: 20503061
references: Arthritis Rheum. 1997 Oct;40(10):1829-37
references: 9336418
references: Semin Arthritis Rheum. 2004 Aug;34(1):465-83
references: 15305245
references: Eur Respir Rev. 2010 Jun;19(116):164-5
references: 20956187
references: Expert Opin Drug Saf. 2005 Jul;4(4):723-30
references: 16011450
references: Clin Rheumatol. 1997 May;16(3):296-304
references: 9184269
references: Arthritis Rheum. 1996 Feb;39(2):272-6
references: 8849378
references: Mil Med. 2004 Apr;169(4):298-300
references: 15132233
references: Rheumatology (Oxford). 2008 Nov;47(11):1647-50
references: 18812430
references: Arthritis Rheum. 1983 Oct;26(10):1269-74
references: 6626285
references: J Clin Rheumatol. 2009 Feb;15(1):29-30
references: 18679135
references: JAMA. 1969 Sep 22;209(12):1861-8
references: 5257599
references: Clin Exp Rheumatol. 2003 Sep-Oct;21(5 Suppl 31):S179-85
references: 14969073
references: Clin Exp Rheumatol. 2001 Nov-Dec;19(6):727-30
references: 11791648