Progressive Interstitial Lung Disease From Prolonged Methotrexate Therapy

Robin L. Kaplan, MD; Dennis H. Waite, MD

[+] Author Affiliations

Accepted for publication Aug 9, 1978.

Reprint requests to the University of Colorado Medical Center, Box C-272, Denver, CO 80262 (Dr Kaplan).

From the Division of Pulmonary Sciences, Department of Medicine, University of Colorado Medical Center, Denver (Dr Kaplan), and the Rose Medical Center, Denver (Dr Waite).

Arch Dermatol. 1978;114(12):1800-1802. doi:10.1001/archderm.1978.01640240042014

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ABSTRACT

ABSTRACT | REFERENCES

• Progressive interstitial fibrosis with roentgenographic honeycombing developed in the case of a psoriatic patient who had been on a regimen of methotrexate for 18 years. Examination revealed a combined restrictive and obstructive defect in pulmonary mechanics and severe compromise of gas transfer across the pulmonary alveolar-capillary membrane. Improvement in the level of arterial blood gases and pulmonary diffusing capacity occurred after discontinuation of methotrexate therapy. Interstitial fibrosis of the lung is a potential complication of methotrexate therapy for psoriasis.

(Arch Dermatol 114:1800-1802, 1978)

REFERENCES

ABSTRACT | REFERENCES

Sostman MD, Matthay RA, Putman CE, et al: Methotrexate pneumonitis . Medicine 55:371-388, 1976;.

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Nesbit M, Krivit W, Heyn R, et al: Acute and chronic effects of methotrexate on hepatic, pulmonary, and skeletal systems . Cancer 37( (suppl) ):1048-1054, 1976;.

Gutin PH, Green MR, Bleyer WA, et al: Methotrexate pneumonitis induced by intrathecal methotrexate therapy . Cancer 38:1529-1534, 1976;.

Goldman GC, Moschella SL: Severe pneumonitis occurring during methotrexate therapy . Arch Dermatol 103:194-197, 1971;.

Whitcomb ME, Schwarz MI, Tormey DC: Methotrexate pneumonitis: Case report and review of the literature . Thorax 27:636-639, 1972;.

Clarysse AM, Cathey WJ, Cartwright GE, et al: Pulmonary disease complicating intermittent therapy with methotrexate . JAMA 209:1861-1864, 1969;.

Filip DJ, Louge GL, Marle TS, et al: Pulmonary and hepatic complications of methotrexate therapy of psoriasis . JAMA 216:881-882, 1971;.

Dietzsch HJ, Lorenz K, Roschlau G: Lungenveranderunger bei methotrexatebehandlung in kindesalter . Dtsch Gesundheitsw 26:174-178, 1971;.

Dreisin RB, Schwarz MI, Theophilopoulos AN, et al: Circulating immune complexes in the idiopathic interstitial pneumonias . N Engl J Med 298:353-357, 1978;.

Chabner BA, Young RC: An in vivo method for monitoring differential effects of chemotherapy on target issues in animals and man: Correlation with plasma pharmacokinetics . J Clin Invest 52:92a, 1973;.

Psoriasis-liver-methotrexate interactions . Arch Dermatol 108:36-42, 1973;.

Calabresi P, Parks RE Jr: Alkylating agents, antimetabolites, hormones, and other antiproliferative agents , in The Pharmacologic Basis of Therapeutics , ed 4. New York, MacMillan Co, 1970;, pp 1360-1364.

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