Journal List > J Korean Rheum Assoc > v.14(3) > 1003571

Sheen, Lim, Shim, Lee, Kang, Song, and Lee: Successful Treatment of Interstitial Pneumonitis Induced by Leflunomide

Abstract

Leflunomide is a disease-modifying antirheumatic drug that has been available in Korea since 2003. Leflunomide induced interstitial pneumonitis has been reported as an adverse effect in other countries but not in Korea. A 57-year-old woman was treated with leflunomide since she had been resistant to methotrexate, hydroxychloroquine and sulfasalazine. She developed high fever, dyspnea, and non-productive cough 3 months after the administration of leflunomide. She was diagnosed leflunomide-induced interstitial pneumonitis based on history, physical, laboratory, radiologic and pathologic findings. The patient was treated by prednisolone 1 mg/kg/day with cholestyramine 24 g/day, resulting in dramatic improvement. Here we report a case of leflunomide induced pneumonitis treated successfully with high dose steroid.

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Fig. 1.
Chest CT on admission shows ground-glass opacity in her lower lung fields.
jkra-14-268f1.tif
Fig. 2.
Chest X ray shows diffuse infiltration on both lung fields (A), 15 days after follow-up chest X-ray reveals resolution of previously noted interstitial infiltration (B).
jkra-14-268f2.tif
Fig. 3.
Open lung biopsy shows focal interstitial lymphocytic infiltration without interstitial fibrosis, these findings suggest acute fibrinous and organizing pneumonia (H&E stain, ∗400).
jkra-14-268f3.tif
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