Rheumatoid Arthritis, Methotrexate Therapy, and Pneumocystis Pneumonia
Authors: Richard L. Leff, John P. Case, Robin McKenzie
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 May 1990Rheumatoid Arthritis, Methotrexate Therapy, and Pneumocystis PneumoniaRichard L. Leff, MD, John P. Case, MD, Robin McKenzie, MDRichard L. Leff, MDSearch for more papers by this author, John P. Case, MDSearch for more papers by this author, Robin McKenzie, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-9-716_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Low-dose methotrexate therapy has a 1% to 5% incidence of pneumonitis (1). However, Pneumocystis carinii pneumonia resembling methotrexate-induced pneumonitis has been reported (2, 3) in two patients. In both cases, concomitant low-dose daily corticosteroids may have contributed to immunosuppression. We report a case of P. carinii pneumonia in a patient with rheumatoid arthritis who was treated with low-dose methotrexate without corticosteroids.A 66-year-old man with rheumatoid arthritis presented with progressive cough, fever, and shortness of breath. Methotrexate therapy had been started 6 months earlier, up to 22.5 mg/wk, with marked improvement in his rheumatoid arthritis. A stable...References1. Carson C, Cannon G, and Egger M. Pulmonary disease during the treatment of rheumatoid arthritis with low dose pulse methotrexate. Semin Arthritis Rheum. 1987;16:186-95. CrossrefMedlineGoogle Scholar2. Perruquet J, Harrington T, and Davis D. Pneumocystis carinii pneumonia following methotrexate therapy for rheumatoid arthritis [Letter]. Arthritis Rheum. 1983;26:1291-2. CrossrefMedlineGoogle Scholar3. Wallis P, Ryatt K, and Constable T. Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for psoriatic arthropathy. Ann Rheum Dis. 1989;48:247-9. CrossrefMedlineGoogle Scholar4. Altz-Smith M, Kendall L, and Stamm A. Cryptococcosis associated with low dose methotrexate for arthritis. Am J Med. 1984;83:179-81. CrossrefGoogle Scholar5. Keegan J and Byrd J. Nocardiosis associated with low dose methotrexate for rheumatoid arthritis [Letter]. J Rheumatol. 1988;15:1585. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Richard L. Leff, MD; John P. Case, MD; Robin McKenzie, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFactors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective StudyEtiology and prognosis of acute respiratory failure in patients with primary malignant brain tumors admitted to the intensive care unitThe immunology of parasite infections in immunocompromised hostsDOES METHOTREXATE INCREASE THE RISK OF INFECTION OR MALIGNANCY?Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature reviewInfections during low-dose methotrexate treatmentin rheumatoid arthritisAn analysis of forty-two wegener's granulomatosis patients treated with methotrexate and prednisoneComparison of oral pulse methotrexate with placebo in the treatment of severe glucocorticosteroid-dependent asthmaThe use of methotrexate for treatment of psoriasis in patients with HIV infectionTreatment of refractory rheumatoid arthritis with a chimeric ANTI-CD4 monoclonal antibodyShould methotrexate be used to treat early rheumatoid arthritis?Low-dose methotrexate in rheumatic diseases—Efficacy, side effects, and risk factors for side effectsMethotrexatePneumocystis Carinii Pneumonia Associated with Low Dose Methotrexate Treatment for Rheumatoid ArthritisMethotrexate in rheumatoid arthritis: can current knowledge and experience justify its use as a first-line disease-modifying agent?Pneumocystis carinii pneumonia associated with weekly methotrexate: cumulative dose of methotrexate and low CD4 cell count may predict this complicationPrevention and Treatment of Pneumocystis PneumoniaThe treatment of wegener's granulomatosis with glucocorticoids and methotrexateAuthors' replyPneumocystis carinii pneumonia as a complication of methotrexate treatment of asthma.Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for rheumatoid arthritis. 1 May 1990Volume 112, Issue 9Page: 716-716KeywordsDyspneaFeversMethotrexatePneumocystisPneumocystis carinii pneumoniaPneumoniaPneumonitisRheumatoid arthritis ePublished: 1 December 2008 Issue Published: 1 May 1990 PDF downloadLoading ...