Neumonitis asociada al uso de metotrexate

Methotrexate pneumonitis is an acute and serious complication characterized by the onset of a dry cough, dyspnea, and fever, with the appearance of a radiological pattern of interstitial infiltrate that requires drug withdrawal. Its pathogenesis is attributed to a hypersensitivity mechanism and it i...

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Bibliographic Details
Main Authors: Pita Merejildo, Wilson, Quezada Jaramillo Prisi, Priscylla, Pino Pin, María José, Uchuari Muñoz, Diana Lisette
Format: Article
Language:Spanish
Published: 2020
Subjects:
Neumonitis
Metrotexate
Toxicidad
Corticoides
Pulmonar
Pneumonitis
Methotrexate
Toxicity
Corticosteroids
Pulmonary
Pneumonite
Metotrexato
Toxicidade
Corticosteróides
Online Access:https://dialnet.unirioja.es/servlet/oaiart?codigo=7999200
Source:RECIMUNDO: Revista Científica de la Investigación y el Conocimiento, ISSN 2588-073X, Vol. 4, Nº. 4, 2020 (Ejemplar dedicado a: Noviembre (Especial)), pags. 200-206
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Neumonitis asociada al uso de metotrexate
Summary: Methotrexate pneumonitis is an acute and serious complication characterized by the onset of a dry cough, dyspnea, and fever, with the appearance of a radiological pattern of interstitial infiltrate that requires drug withdrawal. Its pathogenesis is attributed to a hypersensitivity mechanism and it is recommended not to reintroduce methotrexate after its resolution. Recognized risk factors are advanced age, diabetes mellitus, hypoalbuminemia, and the extra-articular manifestations of rheumatoid arthritis, especially pulmonary arthritis. Treatment with high-dose glucocorticoids and respiratory support measures favor complete clinical resolution, although mortality reaches 10-18% of series. We present the case of a 57-year-old male patient who has a history of rheumatoid arthritis treated with methotrexate for 8 months, who presented a clinical picture of 5 days of evolution characterized by dyspnea on medium efforts, dry cough, whose symptoms progressed until presenting signs of hypoxemic type acute respiratory failure. He was admitted in need of mechanical ventilation. Imaging examinations were performed that showed a disseminated bilateral interstitial pattern. That after ruling out more frequent pathologies, the clinical picture was associated with methotrexate pneumonitis. With such a diagnosis, corticosteroids were administered with a favorable outcome.

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