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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| Language: | Spanish |
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2020
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| 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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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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Spanish
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Neumonitis
Metrotexate Toxicidad Corticoides Pulmonar Pneumonitis Methotrexate Toxicity Corticosteroids Pulmonary Pneumonite Metotrexato Toxicidade Corticosteróides Pulmonar |
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Neumonitis
Metrotexate Toxicidad Corticoides Pulmonar Pneumonitis Methotrexate Toxicity Corticosteroids Pulmonary Pneumonite Metotrexato Toxicidade Corticosteróides Pulmonar Pita Merejildo, Wilson Quezada Jaramillo Prisi, Priscylla Pino Pin, María José Uchuari Muñoz, Diana Lisette Neumonitis asociada al uso de metotrexate |
| description |
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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| format |
Article
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| author |
Pita Merejildo, Wilson
Quezada Jaramillo Prisi, Priscylla Pino Pin, María José Uchuari Muñoz, Diana Lisette |
| author_facet |
Pita Merejildo, Wilson
Quezada Jaramillo Prisi, Priscylla Pino Pin, María José Uchuari Muñoz, Diana Lisette |
| author_sort |
Pita Merejildo, Wilson
|
| title |
Neumonitis asociada al uso de metotrexate
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| title_short |
Neumonitis asociada al uso de metotrexate
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| title_full |
Neumonitis asociada al uso de metotrexate
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| title_fullStr |
Neumonitis asociada al uso de metotrexate
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| title_full_unstemmed |
Neumonitis asociada al uso de metotrexate
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| title_sort |
neumonitis asociada al uso de metotrexate
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| publishDate |
2020
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| url |
https://dialnet.unirioja.es/servlet/oaiart?codigo=7999200
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| _version_ |
1714993129504899072
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| spelling |
dialnet-ar-18-ART00014667992021-10-28Neumonitis asociada al uso de metotrexatePita Merejildo, WilsonQuezada Jaramillo Prisi, PriscyllaPino Pin, María JoséUchuari Muñoz, Diana LisetteNeumonitisMetrotexateToxicidadCorticoidesPulmonarPneumonitisMethotrexateToxicityCorticosteroidsPulmonaryPneumoniteMetotrexatoToxicidadeCorticosteróidesPulmonarMethotrexate 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.A pneumonite por metotrexato é uma complicação aguda e grave caracterizada pelo aparecimento de tosse seca, disp-neia e febre, com o aparecimento de um padrão radiológico de infiltrado intersticial que requer a suspensão do medica-mento. Sua patogênese é atribuída a um mecanismo de hipersensibilidade e recomenda-se não reintroduzir o metotrexato após sua resolução. Os fatores de risco reconhecidos são idade avançada, diabetes mellitus, hipoalbuminemia e as manifestações extra-articulares da artrite reumatoide, especialmente artrite pulmonar. O tratamento com glicocorticoides em altas doses e medidas de suporte respiratório favorecem a resolução clínica completa, embora a mortalidade alcance 10-18% das séries. Apresentamos o caso de um paciente do sexo masculino, 57 anos, com história de artrite reumatoide tratada com metotrexato há 8 meses, que apresentava quadro clínico de 5 dias de evolução caracterizado por dispneia aos médios esforços, tosse seca, cujos sintomas progrediram até apresentar sinais de insuficiência respiratória aguda do tipo hipoxêmico. Ele foi internado com necessidade de ventilação mecânica. Foram realizados exames de imagem que mostraram um padrão intersticial bilateral disseminado. Que após afastar patologias mais frequentes, o quadro clínico foi associado a pneumonite por metotrexato. Com esse diagnóstico, os corticosteroides foram administrados com um resultado favorável.La neumonitis por metotrexate es una complicación aguda y grave que se caracteriza por la instauración de tos seca, disnea y fiebre, con aparición de un patrón radiológico de infiltrado intersticial que obliga a la retirada del fármaco. Su patogenia se atribuye a un mecanismo de hipersensibilidad y se recomienda no reintroducir el metotrexato tras su resolución. Los factores de riesgo reconocidos son la edad avanzada, la diabetes mellitus, la hipoalbuminemia y las manifestaciones extra articulares de la artritis reumatoide, especialmente la pulmonar. El tratamiento con glucocorticoides a dosis altas y las medidas de soporte respiratorio favorecen la resolución clínica completa, aunque la mortalidad alcanza el 10-18% de las series. Presentamos el caso de un paciente masculino de 57 años que tiene antecedentes de artritis reumatoidea tratado con metotrexato desde hace 8 meses, que presento un cuadro clínico de 5 días de evolución caracterizado por disnea de medianos esfuerzos, tos seca, cuyos síntomas progresaron hasta presentar signos de insuficiencia respiratoria aguda tipo hipoxemica. Fue ingresado con necesidad de ventilación mecánica. Se realizaron exámenes de imágenes que mostraron un patrón intersticial bilateral diseminado. Que posterior a descarte de patologías más frecuentes, se asoció el cuadro clínico a neumonitis por metotrexato. Con tal diagnóstico se procedió a la administración de corticoides con evolución favorable.2020text (article)application/pdfhttps://dialnet.unirioja.es/servlet/oaiart?codigo=7999200(Revista) ISSN 2588-073XRECIMUNDO: Revista Científica de la Investigación y el Conocimiento, ISSN 2588-073X, Vol. 4, Nº. 4, 2020 (Ejemplar dedicado a: Noviembre (Especial)), pags. 200-206spaLICENCIA DE USO: Los documentos a texto completo incluidos en Dialnet son de acceso libre y propiedad de sus autores y/o editores. Por tanto, cualquier acto de reproducción, distribución, comunicación pública y/o transformación total o parcial requiere el consentimiento expreso y escrito de aquéllos. Cualquier enlace al texto completo de estos documentos deberá hacerse a través de la URL oficial de éstos en Dialnet. 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