Abstract
Low dose methotrexate has been used successfully to treat patients with refractory rheumatoid arthritis.1 Methotrexate-induced pneumonitis occurs in about 1 to 5% of patients, although opportunistic infections have also been reported.1 We report a case of fatal pneumocystis carinii pneumonia (PCP) in an otherwise healthy female patient treated with methotrexate for rheumatoid arthritis and review the literature.
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References
- Tugwell P, Bennett K, Gent M. Methotrexate in rheumatoid arthritis. Indications, contraindications, efficacy, and safety. Ann Int Med 1987; 107(3): 358-66.
- Flood DA, Chan CK, Pruzanski W. Pneumocystis carinii pneumonia associated with methotrexate therapy in rheumatoid arthritis. Journal of Rheumatology 1991; 18: 1254-6.
- Kuitert LM, Harrison AC. Pneumocystis carinii pneumonia as a complication of methotrexate treatment of asthma. Thorax. 1991; 46(12): 936-7.
- Stenger AAME, Houtman PM, Bruyn GAW, et al; Pneumocystis carinii pneumonia associated with low dose methotrexate treatment for rheumatoid arthritis. Scand J Rheumatol 1994; 23: 51-3.
- Wollner A, Mohle-Boetani J, Lambert RE, et al; Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for rheumatoid arthritis. Thorax 1991; 46(3): 205-7.
- Shiroky JB, Frost A, Skelton JD, et al; Complications of immunosuppression associated with weekly low dose methotrexate. J Rheumatol 1991; 18: 1172-75.
- Vallerand H, Cossart C, Milosevic D, et al; Fatal pneumocystis pneumonia in asthmatic patient treated with methotrexate (letter). Lancet 1992; 339(8808): 1551.
- Perruquet JL, Harrington TM, Davis DE. Pneumocystis carinii pneumonia following methotrexate therapy for rheumatoid arthritis (letter). Arthritis Rheum 1983; 26(10): 1291-2.
- Wallis PJ, Ryatt KS, Constable TJ. Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for psoriatic arthropathy. Ann Rheum Dis 1989; 48(3): 247-9.
- Lang B, Riegel W, Peters T, et al; Low dose methotrexate therapy for rheumatoid arthritis complicated by pancytopenia and pneumocystis carinii pneumonia. Journal of Rheumatology 1991; 18(8): 1257-9.
- Leff RL, Case JP, McKenzie R. Rheumatoid arthritis, methotrexate therapy and pneumocystis pneumonia (letter). Ann Int Med 1990; 112(9): 716.
- Daly H, Boyle J, Roberts C, et al; Interaction between methotrexate and non-steroidal anti-inflammatory drugs (letter). Lancet 1986; 1(8480): 557.
- Imokawa S, Colby T V, Leslie K O, et al; Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients. European Respiratory Journal 2000; 15: 373 - 381
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