Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis.

Journal Article (Journal Article)

Three of 95 patients with rheumatoid arthritis who were being treated with low-dose (5 to 15 mg/wk) methotrexate sodium developed the clinical, radiographic, and pathologic features of methotrexate-associated pulmonary injury. Marked hypoxemia emphasized the severity of illness in our patients; lowest oxygen pressure values for each patient were 35 mm Hg, 42 mm Hg, and 45 mm Hg. The management of our patients with a pulmonary toxic reaction to methotrexate included discontinuing the drug treatment, antibiotic therapy until an infectious cause was excluded, and high-dose methylprednisolone. Two patients recovered and one died. Contrary to an earlier report that suggested that pneumonitis occurred only with methotrexate sodium doses exceeding 15 mg/wk, our three cases demonstrate that a severe pulmonary toxic reaction may also complicate low-dose weekly methotrexate therapy of rheumatoid arthritis.

Full Text

Duke Authors

Cited Authors

  • St Clair, EW; Rice, JR; Snyderman, R

Published Date

  • November 1985

Published In

Volume / Issue

  • 145 / 11

Start / End Page

  • 2035 - 2038

PubMed ID

  • 4062454

International Standard Serial Number (ISSN)

  • 0003-9926

Digital Object Identifier (DOI)

  • 10.1001/archinte.145.11.2035


  • eng

Conference Location

  • United States