van der Veen M J, Dekker J J, Dinant H J, van Soesbergen R M, Bijlsma J W
Department of Rheumatology, University Hospital Utrecht, The Netherlands.
J Rheumatol. 1995 Sep;22(9):1766-8.
We report the fatal disease course of 2 aged patients with rheumatoid arthritis (RA). Both had respiratory complaints after 10-15 weeks of treatment with methotrexate (MTX). After withdrawal of MTX, and despite the use of corticosteroids and ventilatory support, both died of respiratory failure. Post mortem examination showed extensive pulmonary fibrosis, bronchiolitis obliterans, and hyperplasia of type II pneumocytes. To our knowledge, this is the first report of fatal pulmonary fibrosis following short courses of low dose MTX therapy for RA.
我们报告了2例老年类风湿关节炎（RA）患者的致命病程。两名患者在使用甲氨蝶呤（MTX）治疗10 - 15周后均出现呼吸道症状。停用MTX后，尽管使用了皮质类固醇和通气支持，两人均死于呼吸衰竭。尸检显示广泛的肺纤维化、闭塞性细支气管炎和II型肺泡上皮细胞增生。据我们所知，这是首次关于低剂量MTX短疗程治疗RA后发生致命性肺纤维化的报告。
