Pulmonary abscess due to leflunomide use in rheumatoid arthritis: a case report

Ulusoy H., Bilgici A., Kuru O., Celenk C.

RHEUMATOLOGY INTERNATIONAL, cilt.25, sa.2, ss.139-142, 2005 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 2
  • Basım Tarihi: 2005
  • Doi Numarası: 10.1007/s00296-004-0493-6
  • Dergi Adı: RHEUMATOLOGY INTERNATIONAL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.139-142
  • Anahtar Kelimeler: infection, leflunomide, pulmonary abscess, rheumatoid arthritis, DE-NOVO SYNTHESIS, T-LYMPHOCYTES, DOUBLE-BLIND, PLACEBO, SAFETY, EFFICACY, METHOTREXATE, MECHANISM
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

A 43-year-old woman had rheumatoid arthritis (RA) for 5 years and complained of fever, arthralgia/ myalgia, and night sweating for a month. She had been receiving only leflunomide (20 mg/day) for 5 months. On admission, there was no evidence of active arthritis or vasculitic lesion. Laboratory evaluation showed an erythrocyte sedimentation rate of 145 mm/h and C-reactive protein of 160 mg/dl. All cultures were negative. Chest radiograph and computed tomography (CT) revealed a pulmonary abscess. Staphylococcus aureus multiplied in the culture of a purulent sample obtained from the abscess under ultrasonography. The leflunomide was stopped, and sultamicillin (IV 4x2 g/day) was started for a further 6 weeks. Four weeks later, the patient had completely recovered and CT showed significant improvement of the pulmonary abscess. Ten milligrams/day of prednisolone and 7.5 mg/week of methotrexate were started for RA treatment. The patient has been under control for 5 months without any further abscess or RA activation.