title: Respiratory failure due to infliximab induced interstitial lung disease.
abstract: Although poorly understood, interstitial lung disease has been reported as a possible complication of tumor necrosis factor alpha inhibitors. We report a case of interstitial lung disease in a 64-year-old man with psoriasis 3 weeks after the initiation of infliximab treatment. The patient had received two fortnightly infusions of infliximab following a short course of methotrexate. Thoracic computed tomography showed bilateral ground glass and interstitial infiltrates, while the results of microbiology and immunologic workup were negative. Likewise, bronchoalveolar lavage detected neither typical nor atypical pathogens. Infliximab-induced interstitial lung injury was suspected and corticosteroid therapy was administered which resulted in rapid clinical and radiological improvement. This is one of the few reported cases of interstitial lung disease due to infliximab in the psoriasis population. The patient had no pre-existing lung pathology, while his previous exposure to methotrexate was minimal and was not temporally associated with the induction of interstitial lung disease.
authors: Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilanti 45-47, 10676 Athens, Greece. Electronic address: sotikaka@yahoo.com.
authors: Sotiris
authors: S
authors: Kakavas
authors: Evangelos
authors: E
authors: Balis
authors: Vasiliki
authors: V
authors: Lazarou
authors: Marousa
authors: M
authors: Kouvela
authors: Georgios
authors: G
authors: Tatsis
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018893:Bronchoalveolar Lavage; D003879:Dermatologic Agents / Q000009:adverse effects*; D006801:Humans; D000069285:Infliximab; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Drug-induced interstitial pneumonia; Infliximab; Interstitial lung disease; Psoriasis; Tumor necrosis factor inhibitor