Browse > Article
http://dx.doi.org/10.4046/trd.2009.66.6.477

A Case of Interstitial Pneumonitis in a Patient with Rheumatoid Arthritis Treated with Leflunomide  

Shin, Ah-Young (Divisions of Rheumatology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea)
Kim, Seung Soo (Divisions of Pulmonology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea)
Kim, Kyung Hee (Divisions of Pulmonology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea)
Ju, Il-Nam (Divisions of Pulmonology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea)
Ko, Hyeok Jae (Divisions of Rheumatology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea)
Publication Information
Tuberculosis and Respiratory Diseases / v.66, no.6, 2009 , pp. 477-481 More about this Journal
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 She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly.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.
Keywords
Leflunomide; Interstitial lung diseases; Rheumatoid arthritis;
Citations & Related Records

Times Cited By SCOPUS : 1
연도 인용수 순위
1 Chikura B, Lane S, Dawson JK. Clinical expression of leflunomide-induced pneumonitis. Rheumatology (Oxford). Forthcoming 2009
2 Sheen DH, Lim MK, Shim SC, Lee SO, Kang SW, Song JK, et al. Successful treatment of interstitial pneumonitis induced by leflunomide. J Korean Rheum Assoc 2007; 14:268-73   DOI   ScienceOn
3 Bartlett RR, Brendel S, Zielinski T, Schorlemmer HU. Leflunomide, an immunorestoring drug for the therapy of autoimmune disorders, especially rheumatoid arthritis. Transplant Proc 1996;28:3074-8   PUBMED
4 Park YB, Lee SK. Leflunomide: a new disease modifying anti-rheumatic drug. J Korean Rheum Assoc 2000;7: 323-32
5 Searles G, McKendry RJ. Methotrexate pneumonitis in rheumatoid arthritis: potential risk factors. Four case reports and a review of the literature. J Rheumatol 1987; 14:1164-71   PUBMED
6 McCurry J. Japan deaths spark concerns over arthritis drug. Lancet 2004;363:461   PUBMED
7 Vallbracht II, Popper HH, Rieber J, Nowak F, Gallenberger S, Piper B, et al. Lethal pneumonitis under leflunomide therapy. Rheumatology (Oxford) 2005;44: 1580-1   DOI   ScienceOn
8 Breedveld FC, Dayer JM. Leflunomide: mode of action in the treatment of rheumatoid arthritis. Ann Rheum Dis 2000;59:841-9   DOI   ScienceOn
9 Lee JH, Cheon WS, Seo YI, Eom KS, Jang SH, Bahn JW, et al. A case of interstitial pneumonitis caused by leflunomide. Tuberc Respir Dis 2005;58:83-8   DOI
10 Kalden JR, Schattenkirchner M, Sörensen H, Emery P, Deighton C, Rozman B, et al. The efficacy and safety of leflunomide in patients with active rheumatoid arthritis: a five-year followup study. Arthritis Rheum 2003; 48:1513-20   DOI   ScienceOn
11 Kremer J, Genovese M, Cannon GW, Caldwell J, Cush J, Furst DE, et al. Combination leflunomide and methotrexate (MTX) therapy for patients with active rheumatoid arthritis failing MTX monotherapy: open-label extension of a randomized, double-blind, placebo controlled trial. J Rheumatol 2004;31:1521-31   PUBMED
12 Chikura B, Sathi N, Lane S, Dawson JK. Variation of immunological response in methotrexate-induced pneumonitis. Rheumatology (Oxford) 2008;47:1647-50   DOI   ScienceOn
13 Savage RL, Highton J, Boyd IW, Chapman P. Pneumonitis associated with leflunomide: a profile of New Zealand and Australian reports. Intern Med J 2006; 36:162-9   DOI   ScienceOn
14 Suissa S, Hudson M, Ernst P. Leflunomide use and the risk of interstitial lung disease in rheumatoid arthritis. Arthritis Rheum 2006;54:1435-9   DOI   ScienceOn