Mycobacterium intracellulare Pulmonary Disease with Endobronchial Caseation in a Patient Treated with Methotrexate.
Methotrexate (MTX) has been established as a standard disease-modifying anti-rheumatic drug. If adequate disease control is achieved for a reasonable period of time, tapering the MTX dosage is recommended because the chronic use of MTX can result in opportunistic infection. We present here a case of a woman with rheumatoid arthritis taking MTX, and the woman developed actively caseating endobronchial Mycobacterium intracellulare disease with pulmonary infiltrations. After discontinuing the MTX, the patient was able to tolerate 18 months of antimycobacterial treatment without flare ups of rheumatoid arthritis, and she completely recovered from nontuberculous mycobacterial respiratory disease.
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University Medicine and Science, Incheon, Korea.
Jin Sun
JS
Park
Eul Sik
ES
Jung
Woosuk
W
Choi
Soo Yong
SY
Park
Min Young
MY
Rim
Inku
I
Yu
Hyeonsu
H
Park
Sang Min
SM
Lee
Jeong-Woong
JW
Park
Sung Hwan
SH
Jeong
Sang Pyo
SP
Lee
Sanghui
S
Park
Arthiritis, Rheumatoid; Bronchial Diseases; Methotrexate; Nontuberculous Mycobacteria; Tuberculosis, Pulmonary