Methotrexate-induced pneumonitis in Crohn’s disease

Case report and review of the literature

  • Nadia D'Andrea | n.dandrea@sanfilipponeri.roma.it UOC Pneumologia, ACO San Filippo Neri, Roma, Italy.
  • Luca Triolo Pneumology Unit, San Filippo Neri General Hospital, Rome, Italy.
  • Giovanna Margagnoni Gastroenterology Unit, San Filippo Neri General Hospital, Rome, Italy.
  • Annalisa Aratari Gastroenterology Unit, San Filippo Neri General Hospital, Rome, Italy.
  • Claudio M. Sanguinetti Pneumology Unit, San Filippo Neri General Hospital, Rome, Italy.

Abstract

Methotrexate (MTX) is a folate-antagonist used in several neoplastic and inflammatory diseases. Reports of pulmonary complications in patients given low-dose MTX therapy are increasing. Pulmonary toxicity from MTX has a variable fre- quency and can present with different forms. Most often MTX-induced pneumonia in patients affected by rheumatoid arthritis (RA) is reported. In this paper we describe a case of MTX-related pneumonitis in a relatively young woman affected by Crohn's disease who presented non-productive cough, fever and dyspnea on exer- cise. Chest X-ray demonstrated bilateral interstitial infil- trates and at computed tomography (CT) ground-glass opac- ities appeared in both lungs. At spirometry an obstructive defect was demonstrated. A rapid improvement of symptoms and the regression of radiographic and spirometric alter- ations was achieved through MTX withdrawal and the intro- duction of corticosteroid therapy.

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Published
2010-07-30
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Section
Case Reports
Keywords:
Crohn’s disease, CT, methotrexate, pneumonitis, spirometry.
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How to Cite
D’Andrea, N., Triolo, L., Margagnoni, G., Aratari, A., & Sanguinetti, C. M. (2010). Methotrexate-induced pneumonitis in Crohn’s disease: Case report and review of the literature. Multidisciplinary Respiratory Medicine, 5(1). https://doi.org/10.4081/mrm.2010.558