Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis : A multicenter study with literature review.
To describe the clinical, laboratory, radiologic, and histopathologic features of methotrexate (MTX) - induced lung injury in a combined cohort of selected patients with rheumatoid arthritis (RA) and all cases reported in the English-language literature.
Retrospective combined cohort review and abstraction from the medical literature.
Case reports were obtained from 6 centers that had 4 or more cases of potential MTX lung injury per site.
RA patients who were seen between 1981 and 1993 and who satisfied predetermined criteria for the presence of MTX lung injury were identified.
Twenty-seven patients satisfied the criteria for definite MTX lung injury, and 2 for probable MTX lung injury.
Predominant clinical features of MTX lung injury included shortness of breath in 27 patients (93.1%), which was present for 23.5 ± 22.3 days (mean+SD), cough in 24 (82.8%), present for 26.9 ± 28.5 days, and fever in 20 (69.0%), present for 10.4 ± 12.8 days.
Five patients (17.2%) died, compared with 12 of 68 (17.6%) reported in the medical literature.
Four of the 6 patients who were re-treated with MTX after an initial pulmonary event developed recurrent lung toxicity, resulting in 2 deaths, compared with a recurrence rate of 3 of 6 in the literature.
MTX lung injury is most often a subacute process, in which symptoms are commonly present for several weeks before diagnosis. (...)
Mots-clés Pascal : Polyarthrite rhumatoïde, Traitement, Chimiothérapie, Méthotrexate, Toxicité, Homme, Poumon pathologie, Symptomatologie, Diagnostic, Epidémiologie, Revue bibliographique, Chronique, Antifolate, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune, Appareil respiratoire pathologie
Mots-clés Pascal anglais : Rheumatoid arthritis, Treatment, Chemotherapy, Methotrexate, Toxicity, Human, Lung disease, Symptomatology, Diagnosis, Epidemiology, Bibliographic review, Chronic, Antifolate, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease, Respiratory disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0528662
Code Inist : 002B02U07. Création : 13/02/1998.