Tuberc Respir Dis.  2009 Jun;66(6):477-481.

A Case of Interstitial Pneumonitis in a Patient with Rheumatoid Arthritis Treated with Leflunomide

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea. kohj8804@catholic.ac.kr
  • 2Division of Pulmonology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.

Abstract

Leflunomide, a disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis has been available in Korea since 2003. Leflunomide-associated interstitial pneumonitis has been appearing recently. A 25-year-old woman with a 12-month history of seronegative rheumatoid arthritis (RA) presented with acute respiratory insufficiency. She developed fever, dyspnea, and non-productive cough. Her medication history included methotrexate (15 mg/week. commencing 1 year prior) and leflunomide (20 mg/day, no loading dose, commencing 4 months prior). She was diagnosed with leflunomide-associated interstitial pneumonitis based on history, physical examination, laboratory and radiologic findings. She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly. We report a case of leflunomide-associated interstitial pneumonitis treated successfully with intravenous high-dose steroid and cholestyramine.

Keyword

Leflunomide; Interstitial lung diseases; Rheumatoid arthritis

MeSH Terms

Adult
Arthritis, Rheumatoid
Cholestyramine Resin
Cough
Dyspnea
Female
Fever
Humans
Isoxazoles
Korea
Lung Diseases, Interstitial
Methotrexate
Physical Examination
Respiratory Insufficiency
Steroids
Cholestyramine Resin
Isoxazoles
Methotrexate
Steroids
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