Progressive interstitial lung disease from prolonged methotrexate therapy

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Abstract
• Progressive interstitial fibrosis with roentgenographic honeycombing developed in the case of a psoriatic patient who had been on a regimen of methotrexate for 18 years. Examination revealed a combined restrictive and obstructive defect in pulmonary mechanics and severe compromise of gas transfer across the pulmonary alveolar-capillary membrane. Improvement in the level of arterial blood gases and pulmonary diffusing capacity occurred after discontinuation of methotrexate therapy. Interstitial fibrosis of the lung is a potential complication of methotrexate therapy for psoriasis. (Arch Dermatol114:1800-1802, 1978)