Article

[Acute respiratory distress syndrome due to pneumonitis following intrathecal methotrexate administration].

Clinique pneumologique, CHU, Rouen, France.
Revue des Maladies Respiratoires (impact factor: 0.59). 05/2003; 20(2 Pt 1):273-7. pp.273-7
Source: PubMed

ABSTRACT Methotrexate, given orally or systemically, is associated with pneumonitis in 7% of cases.
This case report describes acute respiratory distress syndrome, due to diffuse pneumonitis, in a patient with malignant non-Hodgkin's lymphoma being treated with combination chemotherapy which included doxorubicin, cyclophosphamide, bleomycin, vindesin and intrathecal methotrexate with G-CSF (filgrastine- Neupogen). The clinical course, the lack of an identifiable infectious agent and the complete response to corticosteroids suggested a drug-induced cause. After ruling out the other chemotherapy agents, methotrexate was considered to be the causal agent. The unusual feature of this case was that pneumonitis developed after intrathecal administration of methotrexate.
Methotrexate-associated respiratory complications can occur with whichever route the drug is administered.

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Keywords

acute respiratory distress syndrome
 
case report
 
cases
 
clinical course
 
combination chemotherapy
 
complete response
 
cyclophosphamide
 
diffuse pneumonitis
 
drug-induced cause
 
identifiable infectious agent
 
intrathecal administration
 
intrathecal methotrexate
 
malignant non-Hodgkin's lymphoma
 
Methotrexate
 
Methotrexate-associated respiratory complications
 
pneumonitis
 

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