title: Leflunomide-induced pulmonary hypertension in a young woman with rheumatoid arthritis: a case report.
abstract: Leflunomide, a disease-modifying antirheumatic drug, has been shown to be effective in the management of rheumatoid arthritis (RA). Among other side effects, systemic hypertension has been described, and also a case of possible pulmonary hypertension (PH) has been reported. Symptomatic PH in RA is rare. We present a 28-year-old woman with a history of RA who consulted our hospital because of severe symptomatic pulmonary hypertension. Two years before admission, she was started on leflunomide. Due to previous evidence of the association of leflunomide with pulmonary hypertension, the drug was stopped. The patient became asymptomatic with normal pulmonary arterial pressure within a year. Given the poor prognosis of idiopathic pulmonary arterial hypertension, the recognition of potentially reversible causes is crucial. Until further evidence is available in a patient who develops pulmonary arterial hypertension, stopping leflunomide should be considered.
authors.affiliation: Cardiology Division and Department of Medicine, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina. paulinoalvarez@hotmail.com
authors.forename: Paulino A
authors.initials: PA
authors.lastname: Alvarez
authors.forename: Ariel K
authors.initials: AK
authors.lastname: Saad
authors.forename: Santiago
authors.initials: S
authors.lastname: Flagel
authors.forename: Octavio
authors.initials: O
authors.lastname: Mazzocchi
authors.forename: Manuel Vazquez
authors.initials: MV
authors.lastname: Blanco
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D014463:Ultrasonography
chemical_list: D018501:Antirheumatic Agents; D007555:Isoxazoles; D000077339:Leflunomide