Methotrexate Induced Pneumonitis: A Review Article

Authors: Chikura, Batsi; Sathi, Navtej; Dawson, Julie K.

Source: Current Respiratory Medicine Reviews, Volume 5, Number 1, February 2009 , pp. 12-20(9)

Publisher: Bentham Science Publishers

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Abstract:

Low dose methotrexate (MTX) is used frequently in a wide variety of conditions. This includes rheumatological conditions such as rheumatoid arthritis (RA) and non-rheumatological conditions such as inflammatory bowel disease. One of the most serious although infrequent side effects of low dose MTX is MTX induced pneumonitis (MTX-P). The latest literature on epidemiology, risk factors, pathophysiology and clinical features of MTX-P will be critically reviewed and highlighted. This review will pay special attention to diagnostic criteria, high resolution computerised tomography (HRCT) scan findings, and when to consider bronchoalveolar lavage (BAL) and lung biopsy. We propose the 2008 diagnostic criteria adapted from existing criteria. We will also discuss the new issue of interstitial lung disease (ILD) in patients receiving both methotrexate and anti-TNF therapy.

Keywords: Methotrexate; interstitial lung disease; pneumonitis; chest high resolution computed tomography (HRCT); diagnostic criteria; tumour necrosis factor (TNF)

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157339809787354038

Publication date: 2009-02-01

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Current Respiratory Medicine Reviews publishes frontier reviews on all the latest advances on respiratory diseases and its related areas e.g. pharmacology, pathogenesis, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in respiratory medicine.