title: Methotrexate-induced pneumonitis in Crohn's disease. Case report and review of the literature.
abstract: Methotrexate (MTX) is a folate-antagonist used in several neoplastic and inflammatory diseases. Reports of pulmonary complications in patients given low-dose MTX therapy are increasing. Pulmonary toxicity from MTX has a variable frequency and can present with different forms. Most often MTX-induced pneumonia in patients affected by rheumatoid arthritis (RA) is reported.In this paper we describe a case of MTX-related pneumonitis in a relatively young woman affected by Crohn's disease who presented non-productive cough, fever and dyspnea on exercise. Chest X-ray demonstrated bilateral interstitial infiltrates and at computed tomography (CT) ground-glass opacities appeared in both lungs. At spirometry an obstructive defect was demonstrated. A rapid improvement of symptoms and the regression of radiographic and spirometric alterations was achieved through MTX withdrawal and the introduction of corticosteroid therapy.
authors.affiliation: Pneumology Unit, San Filippo Neri General Hospital, Rome, Italy. n.dandrea@sanfilipponeri.roma.it.
authors.forename: Nadia
authors.initials: N
authors.lastname: D'Andrea
authors.forename: Luca
authors.initials: L
authors.lastname: Triolo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Margagnoni
authors.forename: Annalisa
authors.initials: A
authors.lastname: Aratari
authors.forename: Claudio M
authors.initials: CM
authors.lastname: Sanguinetti