Tuberc Respir Dis.  2004 Feb;56(2):203-209. 10.4046/trd.2004.56.2.203.

A Case of Hypersensitivity Pneumonitis Caused by Methotrexate

• Suh HJ
• Park EH
• Chung MP
• Shin SC
• Jeon KM
• Yu CM
• Pyun YJ
• Lee KS
• Han J

• KMID: 2132474
• DOI: http://doi.org/10.4046/trd.2004.56.2.203

Abstract

BACKGROUND: Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.

Keyword

Methotrexate; Hypersensitivity pneumonitis

MeSH Terms

Alveolitis, Extrinsic Allergic*
Arthritis, Rheumatoid
Cryptogenic Organizing Pneumonia
Granuloma
Humans
Hypersensitivity*
Korea
Lung Diseases
Lung Diseases, Interstitial
Lung Injury
Lymphoma, Non-Hodgkin
Methotrexate*
Osteosarcoma
Pneumonia
Psoriasis
Sarcoidosis
Wegener Granulomatosis
Methotrexate