Abiyarghamsari Mahdiye, Ahmadzadeh Arman
Department of Clinical Pharmacy, School of Pharmacy Shahid Beheshti University of Medical Sciences Tehran Iran.
Department of Internal Medicines Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran.
Clin Case Rep. 2024 Dec 30;13(1):e9615. doi: 10.1002/ccr3.9615. eCollection 2025 Jan.
Rheumatoid arthritis (RA) is a systemic autoimmune disorder with both articular and extra-articular manifestations, including rare pulmonary complications. We report a case of a 65-year-old male with long-standing RA who developed multiple cavitary pulmonary nodules following prolonged leflunomide therapy. Diagnostic evaluation excluded infectious, neoplastic, and autoimmune causes. Bronchoscopy and biopsy confirmed an acute suppurative inflammatory process with central necrosis. Discontinuation of leflunomide resulted in the resolution of pulmonary nodules. This case highlights the need for vigilance regarding potential pulmonary toxicity in RA patients receiving leflunomide and underscores the importance of prompt recognition and management of drug-induced complications.
类风湿关节炎（RA）是一种全身性自身免疫性疾病，具有关节和关节外表现，包括罕见的肺部并发症。我们报告一例65岁男性，患有长期类风湿关节炎，在接受来氟米特长期治疗后出现多个空洞性肺结节。诊断评估排除了感染、肿瘤和自身免疫性病因。支气管镜检查和活检证实为伴有中央坏死的急性化脓性炎症过程。停用 来氟米特后肺结节消退。该病例强调了对接受来氟米特治疗的类风湿关节炎患者潜在肺部毒性保持警惕的必要性，并强调了及时识别和处理药物引起的并发症的重要性。
