Tuberc Respir Dis > Volume 66(6); 2009 > Article
Tuberculosis and Respiratory Diseases 2009;66(6):477-481.
DOI: https://doi.org/10.4046/trd.2009.66.6.477    Published online June 1, 2009.
A Case of Interstitial Pneumonitis in a Patient with Rheumatoid Arthritis Treated with Leflunomide.
Ah Young Shin, Seung Soo Kim, Kyung Hee Kim, Il Nam Ju, Hyeok Jae Ko
1Division of Rheumatology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea. kohj8804@catholic.ac.kr
2Division of Pulmonology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
Abstract
Leflunomide, a disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis has been available in Korea since 2003. Leflunomide-associated interstitial pneumonitis has been appearing recently. A 25-year-old woman with a 12-month history of seronegative rheumatoid arthritis (RA) presented with acute respiratory insufficiency. She developed fever, dyspnea, and non-productive cough. Her medication history included methotrexate (15 mg/week. commencing 1 year prior) and leflunomide (20 mg/day, no loading dose, commencing 4 months prior). She was diagnosed with leflunomide-associated interstitial pneumonitis based on history, physical examination, laboratory and radiologic findings. She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly. We report a case of leflunomide-associated interstitial pneumonitis treated successfully with intravenous high-dose steroid and cholestyramine.
Key Words: Leflunomide, Interstitial lung diseases, Rheumatoid arthritis


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