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. |
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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 She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly.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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