대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

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대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesImaging Conference Cases

Case No : 9

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  • Age/Sex 56 / F
  • Case Title 56-year-old woman with progressive dyspnea and cough. On medication for rheumatoid arthritis Discusser: Resident from Samsung Medical Center
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Diagnosis With Brief Discussion

Courtesy
Asan Medical Center
Discussion
Methotrexate (MTX)
- Folic acid antagonist that inhibits cellular reproduction
- Treatment of malignancy
- Low dose: psoriasis, pemphigus, asthma, primary biliary cirrhosis, inflammatory bowel disease, rheumatoid arthritis

MTX induced lung injury
- Acute hypersensitivity pneumonitis and respiratory failure
- Subacute cellular interstitial pneumonitis
- Pulmonary infiltrates and eosinophilia
- Pulmonary fibrosis
- Acute pulmonary edema
- Acute permeability edema with or without ARDS
- Alveolar hemorrhage (1 case)
- Bronchospasm? laryngeal edema and anaphylactic shock
- Pleural effusion
- Chest pain
- Opportunistic infectious pneumonia

MTX pneumonitis
- Usually reversible, presumably as a result of hypersensitivity reaction, but chronic interstitial fibrosis, NSIP, BOOP can develop.
- Symptoms and signs of toxicity: days to several years after initiation of therapy
Keywords
Lung, Iatrogenic lung disease, Drug complication,
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Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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