Hirabayashi Yu, Shimizu Hisahiro, Kobayashi Nobuyuki, Kudo Koichiro
Department of Respiratory Medicine, International Medical Center of Japan, Toyama, Tokyo.
Intern Med. 2006;45(10):689-91. doi: 10.2169/internalmedicine.45.1455. Epub 2006 Jun 15.
Leflunomide is a disease-modifying antirheumatic drug (DMARD) that has been available in Japan since August 2003. Leflunomide-induced interstitial pneumonitis has not been reported as an adverse effect in other countries. We report a suspected case of leflunomide-induced interstitial pneumonitis. A 77-year-old woman with rheumatoid arthritis and a history of methotrexate-induced pneumonitis developed sudden-onset dyspnea on exertion about 2 months after the administration of leflunomide. She maintained a high concentration of an active metabolite of leflunomide for more than 3 weeks after withdrawal of the drug. She did not respond to treatment and died. Leflunomide must be administered with caution to patients with a history of interstitial pneumonitis or drug-induced pneumonitis. If leflunomide-induced pneumonitis is suspected, the plasma concentration must be immediately checked, along with elimination and withdrawal of the medication.
来氟米特是一种改善病情抗风湿药（DMARD），自2003年8月起在日本上市。在其他国家，来氟米特诱发的间质性肺炎尚未作为不良反应报道。我们报告1例疑似来氟米特诱发的间质性肺炎病例。1名77岁女性，患类风湿关节炎，有甲氨蝶呤诱发肺炎病史，在服用来氟米特约2个月后出现劳力性突发呼吸困难。停药后，她的来氟米特活性代谢物浓度持续3周以上处于高水平。她对治疗无反应，最终死亡。对于有间质性肺炎或药物性肺炎病史的患者，使用来氟米特时必须谨慎。如果怀疑是来氟米特诱发的肺炎，必须立即检查血浆浓度，并停药及促进药物消除。
