open access

Vol 82, No 6 (2014)
CASE REPORTS
Submitted: 2014-10-22
Accepted: 2014-10-22
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Acute interstitial pneumonia in patient with rheumatoid arthritis treated with leflunomide

Izabela Siemion-Szcześniak, Iwona Bartoszuk, Małgorzata Bartosiewicz, Lilia Jakubowska, Stefan Wesołowski, Jan Kuś
DOI: 10.5603/PiAP.2014.0075
·
Pneumonol Alergol Pol 2014;82(6):568-575.

open access

Vol 82, No 6 (2014)
CASE REPORTS
Submitted: 2014-10-22
Accepted: 2014-10-22

Abstract

Leflunomide (LEF) is an isoxazole derivative used as disease-modifying anti-rheumatic drug (DMARD) in the treatment of rheumatoid arthritis (RA). It is effective and safe in patients with active RA, in whom standard treatment is insufficient or contraindicated, but it can cause interstitial lung disease (ILD). Identified risk factors for LEF-induced ILD include pre-existing ILD, cigarette smoking, low body weight, and use of loading dose. LEF should be avoided in patients with pre-existing ILD. We present a case of 59-year-old male with RA and a history of smoking and methotrexate (MTX) treatment, who developed dyspnoea, non-productive cough, and fever about two months after the administration of LEF. The clinical and radiological presentation was of acute pneumonia. The patient was treated with methylprednisolone pulse, prednisone, and cyclophosphamide, but he died of respiratory failure.

Abstract

Leflunomide (LEF) is an isoxazole derivative used as disease-modifying anti-rheumatic drug (DMARD) in the treatment of rheumatoid arthritis (RA). It is effective and safe in patients with active RA, in whom standard treatment is insufficient or contraindicated, but it can cause interstitial lung disease (ILD). Identified risk factors for LEF-induced ILD include pre-existing ILD, cigarette smoking, low body weight, and use of loading dose. LEF should be avoided in patients with pre-existing ILD. We present a case of 59-year-old male with RA and a history of smoking and methotrexate (MTX) treatment, who developed dyspnoea, non-productive cough, and fever about two months after the administration of LEF. The clinical and radiological presentation was of acute pneumonia. The patient was treated with methylprednisolone pulse, prednisone, and cyclophosphamide, but he died of respiratory failure.

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Keywords

interstitial lung disease, leflunomide, drug toxity, rheumatoid arthritis

About this article
Title

Acute interstitial pneumonia in patient with rheumatoid arthritis treated with leflunomide

Journal

Advances in Respiratory Medicine

Issue

Vol 82, No 6 (2014)

Pages

568-575

DOI

10.5603/PiAP.2014.0075

Bibliographic record

Pneumonol Alergol Pol 2014;82(6):568-575.

Keywords

interstitial lung disease
leflunomide
drug toxity
rheumatoid arthritis

Authors

Izabela Siemion-Szcześniak
Iwona Bartoszuk
Małgorzata Bartosiewicz
Lilia Jakubowska
Stefan Wesołowski
Jan Kuś

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