African Journal of Thoracic and Critical Care Medicine (Oct 2022)

Cases

  • M Agarwal,
  • K K Sharma,
  • K Deokar,
  • N Bharti

DOI
https://doi.org/10.7196/AJTCCM.2022.v28i3.254

Abstract

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Methotrexate, an immunomodulatory agent used for a wide variety of indications, can cause pulmonary toxicity in the form of pneumonitis, organising pneumonia, pulmonary fibrosis, pleural effusion, pulmonary infections or lymphoproliferative disease. We report a case of methotrexate pneumonitis in a patient with gestational trophoblastic neoplasia. The diagnosis of methotrexate pneumonitis is challenging, as the signs and symptoms can be caused by intercurrent infection, concomitant medications or an underlying disease condition. A high index of suspicion is required for diagnosis. Management consists of drug discontinuation and steroids in patients with respiratory failure.