METHOTREXATE PULMONARY TOXICITY

TOPIC: Diffuse Lung Disease TYPE: Global Case Reports INTRODUCTION: interstitial lung diseases are an heterogeneous group of respiratory with difficult diagnosis. The study bronchoalvolar lavage (BAL) by flow cytometry may define typical patterns in different diseases, providing some help the differential CASE PRESENTATION: We report a case history rheumatoid arthritis, who shows diffuse injury chest x-ray.The bronchoalveolar showed increase lymphocyte subpopulations, specifically CD4 + lymphocytes (CD4 / CD8 ratio = 1.33), respect to values ??observed blood. DISCUSSION: Metorexate is antineoplastic and anti-inflammatory drug, competitively inhibits dihydrofolate reductase, enzyme that reduces folic acid tetrahydrofolic acid, inhibiting DNA synthesis. One most common serious adverse reactions described acute pneumonitis, which progresses pulmonary fibrosis 10% patients.Methotrexate toxicity presents as lymphocytic alveolitis increased ratio. In these cases, immediate withdrawal drug corticosteroids administration essential, leading rapid improvement patient's evolution. CONCLUSIONS: BAL helpful discriminate between diseases. REFERENCE #1: Jakubovic BD, Donovan A, Webster PM, Shear NH. Methotrexate-induced toxicity. Can Respir J. 2013;20(3):153-155. DISCLOSURES: No relevant relationships Isabel Rodríguez Martín, source=Web Response