scholarly journals Methotrexate-induced lung damage in a patient with rheumatoid arthritis

2021 ◽  
Vol 93 (3) ◽  
pp. 295-299
Author(s):  
Liubov A. Ponomareva ◽  
Daria V. Gurova ◽  
Elena N. Popova ◽  
Natalia V. Chebotareva ◽  
Inna B. Bondarenko ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Disease ◽  
Drug Withdrawal ◽  
Methotrexate Therapy ◽  
Lung Damage ◽  
Main Condition ◽  
Drug Induced ◽  
Instrumental Data ◽  
Favorable Clinical Outcome ◽  
Interstitial Pulmonary Disease

We herein report a case of interstitial lung disease secondary to the use of methotrexate in a patient with rheumatoid arthritis. Differential diagnosis between pneumonitis caused by methotrexate in patients treated with basic methotrexate therapy and interstitial pulmonary disease associated with rheumatoid arthritis is based on the clinical examination and instrumental data. The main condition for favorable clinical outcome in all drug-induced lung disease is drug withdrawal, what was proven in our report.

scholarly journals Serum Metabolomic Profiles of Rheumatoid Arthritis Patients With Acute-Onset Diffuse Interstitial Lung Disease

2019 ◽  
Vol 14 ◽  
pp. 117727191987047 ◽  
Author(s):  
Hiroshi Furukawa ◽  
Shomi Oka ◽  
Kota Shimada ◽  
Atsushi Hashimoto ◽  
Akiko Komiya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Stable State ◽  
Area Under The Curve ◽  
Stable Condition ◽  
Hierarchical Cluster ◽  
Acute Onset ◽  
Serum Samples ◽  
Drug Induced

Objective: Acute-onset diffuse interstitial lung disease (AoDILD) includes acute exacerbation of interstitial lung disease (ILD), drug-induced ILD, and Pneumocystis pneumonia, and frequently occurs in patients with rheumatoid arthritis (RA). Since AoDILD causes a poor prognosis in RA, biomarkers for AoDILD were eagerly desired. Metabolomic analyses were extensively performed in cancer patients and successfully generated better diagnostic biomarkers. In the present study, serum metabolomic profiles of AoDILD in RA were investigated to generate better potential metabolomic biomarkers. Methods: Serum samples of 10 RA patients with AoDILD were collected on admission and in a stable state, more than 3 months before the admission. Serum metabolomic analyses were conducted on the samples from these RA patients with AoDILD. Results: Apparently distinct serum metabolomic profiles in AoDILD were not observed in univariate or hierarchical cluster analyses. Partial least squares-discriminant analysis (PLS-DA) was performed to select candidate metabolites based on variable importance in projection (VIP) scores. The PLS-DA model generated from the four metabolites with VIP scores more than 2.25 (mannosamine, alliin, kynurenine, and 2-hydroxybutyric acid) could successfully discriminate AoDILD from the stable condition (area under the curve: 0.962, 95% confidence interval: 0.778–1.000). Conclusion: It was demonstrated that metabolomic profiling was useful to generate better biomarkers in AoDILD.

Acute lung disease associated with low-dose pulse methotrexate therapy in patients with rheumatoid arthritis

1983 ◽  
Vol 26 (10) ◽  
pp. 1269-1274 ◽  
Author(s):  
Grant W. Cannon ◽  
John R. Ward ◽  
Daniel O. Clegg ◽  
Cecil O. Samuelson ◽  
Thomas M. Abbott
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Disease ◽  
Low Dose ◽  
Methotrexate Therapy

scholarly journals Decision-Making Strategy for the Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD)

2021 ◽  
Vol 10 (17) ◽  
pp. 3806
Author(s):  
Hideaki Yamakawa ◽  
Takashi Ogura ◽  
Hideto Kameda ◽  
Tomoo Kishaba ◽  
Tae Iwasawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Antimicrobial Agents ◽  
Diffuse Alveolar Damage ◽  
Usual Interstitial Pneumonia ◽  
Pneumocystis Pneumonia ◽  
High Dose ◽  
Drug Induced ◽  
Radiological Patterns

Rheumatoid arthritis (RA) is a common type of autoimmune arthritis. Patient clinical outcomes might be influenced by numerous respiratory diseases, but interstitial lung disease (ILD) is the most important comorbidity. RA-associated ILD (RA-ILD) is divided into acute/subacute and chronic forms. In the acute/subacute course, if the disease is severe as indicated by a diffuse alveolar damage pattern, high-dose corticosteroids combined with antimicrobial agents should be promptly initiated while considering the differential diagnoses, primarily acute exacerbation (AE) of RA-ILD, drug-induced pneumonitis, and Pneumocystis pneumonia. As initial therapeutic management in the chronic course, the RA itself should be stabilized without delay; thereafter, the activity of ILD itself can be stabilized, considering the safety of each anti-rheumatic drug. The formation of the usual interstitial pneumonia (UIP) pattern is the most important determinant because lung function can worsen more quickly with this pattern. However, because clinicians can fail to identify specific radiological patterns, it is important to determine whether each patient with RA-ILD has UIP-like lesions such as subpleural reticulation, traction bronchiectasis, and honeycombing especially progressively enlarged cysts. In patients with progressive RA-ILD and high risk for infection or AE of ILD in whom fibrosis is dominant, clinicians should consider starting an anti-fibrotic agent.

Lung involvement and drug-induced lung disease in patients with rheumatoid arthritis

2013 ◽  
Vol 9 (7) ◽  
pp. 649-657 ◽  
Author(s):  
Fabiola Atzeni ◽  
Luigi Boiardi ◽  
Salvatore Sallì ◽  
Maurizio Benucci ◽  
Piercarlo Sarzi-Puttini
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Disease ◽  
Lung Involvement ◽  
Drug Induced

scholarly journals Biomarkers for interstitial lung disease and acute-onset diffuse interstitial lung disease in rheumatoid arthritis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110225
Author(s):  
Hiroshi Furukawa ◽  
Shomi Oka ◽  
Takashi Higuchi ◽  
Kota Shimada ◽  
Atsushi Hashimoto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
Poor Prognosis ◽  
Pneumocystis Pneumonia ◽  
Acute Onset ◽  
Surfactant Protein D ◽  
Drug Induced

Interstitial lung disease (ILD) is frequently a complication of rheumatoid arthritis (RA) as an extra-articular manifestation which has a poor prognosis. Acute-onset diffuse ILD (AoDILD) occasionally occurs in RA and includes acute exacerbation of ILD, drug-induced ILD, and Pneumocystis pneumonia. AoDILD also confers a poor prognosis in RA. Previously-established biomarkers for ILD include Krebs von den lungen-6 and surfactant protein-D originally defined in patients with idiopathic pulmonary fibrosis; the sensitivity of these markers for RA-associated ILD (RA-ILD) is low. Although many studies on ILD markers have been performed in idiopathic pulmonary fibrosis, only a few validation studies in RA-ILD or AoDILD have been reported. Biomarkers for RA-ILD and AoDILD are thus still required. Recently, genomic, cytokine, antibody, and metabolomic profiles of RA-ILD or AoDILD have been investigated with the aim of improving biomarkers. In this review, we summarize current preliminary data on these potential biomarkers for RA-ILD or AoDILD. The development of biomarkers on RA-ILD has only just begun. When validated, such candidate biomarkers will provide valuable information on pathogenesis, prognosis, and drug responses in RA-ILD in future.

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