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Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis.

Publication ,  Journal Article
St Clair, EW; Rice, JR; Snyderman, R
Published in: Arch Intern Med
November 1985

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.

Duke Scholars

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

November 1985

Volume

145

Issue

11

Start / End Page

2035 / 2038

Location

United States

Related Subject Headings

  • Pulmonary Fibrosis
  • Middle Aged
  • Methylprednisolone
  • Methotrexate
  • Male
  • Immunosuppressive Agents
  • Humans
  • General & Internal Medicine
  • Female
  • Drug Administration Schedule
 

Citation

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St Clair, E. W., Rice, J. R., & Snyderman, R. (1985). Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis. Arch Intern Med, 145(11), 2035–2038. https://doi.org/10.1001/archinte.145.11.2035
St Clair, E. W., J. R. Rice, and R. Snyderman. “Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis.Arch Intern Med 145, no. 11 (November 1985): 2035–38. https://doi.org/10.1001/archinte.145.11.2035.
St Clair EW, Rice JR, Snyderman R. Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis. Arch Intern Med. 1985 Nov;145(11):2035–8.
St Clair, E. W., et al. “Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis.Arch Intern Med, vol. 145, no. 11, Nov. 1985, pp. 2035–38. Pubmed, doi:10.1001/archinte.145.11.2035.
St Clair EW, Rice JR, Snyderman R. Pneumonitis complicating low-dose methotrexate therapy in rheumatoid arthritis. Arch Intern Med. 1985 Nov;145(11):2035–2038.

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

November 1985

Volume

145

Issue

11

Start / End Page

2035 / 2038

Location

United States

Related Subject Headings

  • Pulmonary Fibrosis
  • Middle Aged
  • Methylprednisolone
  • Methotrexate
  • Male
  • Immunosuppressive Agents
  • Humans
  • General & Internal Medicine
  • Female
  • Drug Administration Schedule