Takeishi Michio, Akiyama Yuji, Akiba Haruhiko, Adachi Daisuke, Hirano Motoharu, Mimura Toshihide
Division of Rheumatology, Saitama Medical School, Saitama, Japan.
J Rheumatol. 2005 Jun;32(6):1160-3.
We describe a 54-year-old woman with rheumatoid arthritis (RA), who developed acute respiratory failure 2 weeks after cessation of 6-week treatment with leflunomide. We diagnosed interstitial pneumonia, probably induced by leflunomide because acute respiratory failure was preceded by elevated serum liver enzyme concentration and hypertension. She showed dramatic improvement with prednisolone and cholestyramine. Prompt treatment may improve the prognosis. In Japan, leflunomide has been implicated as a possible cause to initiate or exacerbate interstitial pneumonia in patients with RA according to postmarketing surveillance. Clinicians should exclude pulmonary disease prior to initiating leflunomide treatment in patients with RA on the basis of a thorough history and physical examination, and chest radiograph.
我们描述了一名54岁的类风湿性关节炎（RA）女性患者，在停用为期6周的来氟米特治疗2周后出现急性呼吸衰竭。我们诊断为间质性肺炎，可能由来氟米特诱发，因为急性呼吸衰竭之前血清肝酶浓度升高且有高血压。她使用泼尼松龙和考来烯胺后有显著改善。及时治疗可能改善预后。在日本，根据上市后监测，来氟米特被认为可能是RA患者发生或加重间质性肺炎的原因。临床医生在对RA患者开始来氟米特治疗前，应根据详尽的病史、体格检查和胸部X线检查排除肺部疾病。
