By James R. Catterall, Edward A. Sheffield (auth.), Professor David A. Isenberg, Dr. Stephen G. Spiro (eds.)

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MTX pneumonitis is uncommon but potentially life-threatening. In a recent study [102], 4 to 130 patients with RA, treated with MTX, developed pneumonitis. The clinical presentation was non-specific, but the acute or subacute onset of a non-productive cough, dyspnoea, fever and rales is characteristic. Histological changes are also non-specific; however, massive lymphocytic interstitial infiltrate and granuloma formation have been reported, and their presence is helpful in differentiating MTX pneumonitis from rheumatic lung disease [103].

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