Unilateral methotrexate-induced lung injury with foreign bodies in the airway: A case report

Haruyasu Sakuranaka; Takashi Nakagawa; Shun Yokota; Eichi Takahashi; Yuji Yamakawa; Akifumi Hirata; Koumei Igei; Naoki Okamoto; Masahiko Ichioka

Respiratory Medicine Case Reports (Jan 2022)

Unilateral methotrexate-induced lung injury with foreign bodies in the airway: A case report

Haruyasu Sakuranaka,
Takashi Nakagawa,
Shun Yokota,
Eichi Takahashi,
Yuji Yamakawa,
Akifumi Hirata,
Koumei Igei,
Naoki Okamoto,
Masahiko Ichioka

Affiliations

Haruyasu Sakuranaka: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan; Corresponding author.
Takashi Nakagawa: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan; Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8601, Japan
Shun Yokota: Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8601, Japan
Eichi Takahashi: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan; Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8601, Japan
Yuji Yamakawa: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan
Akifumi Hirata: Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8601, Japan
Koumei Igei: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan; Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8601, Japan
Naoki Okamoto: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan
Masahiko Ichioka: Department of Respiratory Medicine, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1, Sakaecho, Itabashi-Ku, Tokyo, 173-0015, Japan

Journal volume & issue: Vol. 36
p. 101573

Abstract

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A 75-year-old woman who had been taking methotrexate presented to our hospital for fever and dry cough. Chest computed tomography showed ground-glass opacity in the upper lobe of the right lung and foreign bodies in the lower lobe of the right bronchus. During bronchoscopy, foreign bodies were removed from the airway. We found increased levels of lymphocytes and a high CD4/CD8 ratio in the bronchoalveolar lavage fluid. Transbronchial lung biopsy revealed lymphocytic infiltration. Methotrexate was discontinued, and the imaging findings improved. Methotrexate-induced lung injury does occur unilaterally. Foreign bodies in the airway might also trigger unilateral methotrexate-induced lung injury.

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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