대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

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,