Toxicidad pulmonar inducida por metotrexato

Pneumonitis is a serious and unpredictable side-effect of methotrexate treatment, appearing acutely or subacutely with cough, fever, dyspnoea and radiological evidence of pulmonary interstitial or alveolar infiltrates. Methotrexate pneumonitis is an idiosyncratic immume reaction and identified risk factors include old age, diabetes, hypoalbuminemia and extraarticular manifestations, particularly rheumatoid lung. Management of this complication include metotrexate withdrawal, high corticosteroid doses and respiratory support, but mortality has been reported in 10-18% of patients.