REVIEW - Methotrexate pulmonary toxicity

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Summary

Expert Opinion on Drug Safety

July 2005, Vol. 4, No. 4, Pages 723-730

Methotrexate pulmonary toxicity

Lateef​‌1, Najia Shakoor​‌2 & A Balk​‌†1

1Rush University Medical Center, Division of Pulmonary & Critical Care

Medicine, 1653 West Congress Parkway, Chicago, IL 60612, USA. rbalk@...

2Rush University Medical Center, Section of Rheumatology, 1653 West Congress

Parkway, Chicago, IL 60612, USA

Methotrexate is a commonly prescribed antineoplastic and immune modulating

compound that has gained wide acceptance in the management of rheumatoid

arthritis, psoriasis, sarcoidosis and a number of neoplastic disorders.

Although generally considered safe and easy to use, methotrexate has been

associated with a number of adverse reactions. Pulmonary toxicity has been

well-described and may take a variety of forms. Pulmonary infiltrates are

the most commonly encountered form of methotrexate pulmonary toxicity and

these infiltrates resemble hypersensitivity lung disease. This discussion

focuses primarily on low-dose methotrexate pulmonary toxicity and will

discuss the diagnosis using clinical, pulmonary function, radiographical and

pathological manifestations. Suggestions for clinical monitoring to detect

adverse effects are given. In addition, management of pulmonary toxicity

through discontinuation of the methotrexate, support and possibly the

administration of corticosteroids is discussed.

http://www.expertopin.com/doi/abs/10.1517/14740338.4.4.723;jsessionid=n0TqzijiO1\

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Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org