Wyss E, Kuhn M, Luzi H P, Reinhart W H
Medizinische Klinik, Kantonsspital Chur.
Schweiz Rundsch Med Prax. 1994 Apr 12;83(15):449-52.
New therapeutic schemes have been proposed recently for treatment of rheumatoid arthritis. Among these, methotrexate at low doses is recommended as basic therapy, already shortly after the diagnosis is established. We report on a 68-year-old female with rheumatoid arthritis who developed bilateral pneumocystis-carinii pneumonia with a lethal course and bilateral sinusitis maxillaris with candida lusitaniae. Various opportunistic infections have been described in the literature after low-dose methotrexate. It is our view that the use of methotrexate in rheumatoid arthritis should still be considered cautiously until further data on the risk-benefit ratio of long-term use become available.
最近已提出了用于治疗类风湿性关节炎的新治疗方案。其中，低剂量甲氨蝶呤被推荐作为基础治疗，在确诊后不久即可使用。我们报告了一名68岁的类风湿性关节炎女性患者，她发展为双侧卡氏肺孢子虫肺炎并导致致命病程，以及双侧上颌窦炎合并葡萄牙念珠菌感染。文献中已描述了低剂量甲氨蝶呤治疗后出现的各种机会性感染。我们认为，在获得关于长期使用甲氨蝶呤风险效益比的更多数据之前，在类风湿性关节炎中使用甲氨蝶呤仍应谨慎考虑。
