title: [Acute interstitial pneumonia in patient with rheumatoid arthritis treated with leflunomide].
abstract: Leflunomide (LEF) is an isoxazole derivative used as disease-modifying anti-rheumatic drug (DMARD) in the treatment of rheumatoid arthritis (RA). It is effective and safe in patients with active RA, in whom standard treatment is insufficient or contraindicated, but it can cause interstitial lung disease (ILD). Identified risk factors for LEF-induced ILD include pre-existing ILD, cigarette smoking, low body weight, and use of loading dose. LEF should be avoided in patients with pre-existing ILD. We present a case of 59-year-old male with RA and a history of smoking and methotrexate (MTX) treatment, who developed dyspnoea, non-productive cough, and fever about two months after the administration of LEF. The clinical and radiological presentation was of acute pneumonia. The patient was treated with methylprednisolone pulse, prednisone, and cyclophosphamide, but he died of respiratory failure.
authors.affiliation: i.siemion@igichp.edu.pl.
authors.forename: Izabela
authors.initials: I
authors.lastname: Siemion-Szcześniak
authors.forename: Iwona
authors.initials: I
authors.lastname: Bartoszuk
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bartosiewicz
authors.forename: Lilia
authors.initials: L
authors.lastname: Jakubowska
authors.forename: Stefan
authors.initials: S
authors.lastname: Wesołowski
authors.forename: Jan
authors.initials: J
authors.lastname: Kuś
mesh_terms: D000208:Acute Disease; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000139:chemically induced* / Q000188:drug therapy; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects*; D000077339:Leflunomide; D008297:Male; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007555:Isoxazoles; D000077339:Leflunomide