PT  - JOURNAL ARTICLE
AU  - Michio Takeishi
AU  - Yuji Akiyama
AU  - Haruhiko Akiba
AU  - Daisuke Adachi
AU  - Motoharu Hirano
AU  - Toshihide Mimura
TI  - Leflunomide induced acute interstitial pneumonia.
DP  - 2005 Jun 01
TA  - The Journal of Rheumatology
PG  - 1160--1163
VI  - 32
IP  - 6
4099  - http://www.jrheum.org/content/32/6/1160.short
4100  - http://www.jrheum.org/content/32/6/1160.full
SO  - J Rheumatol2005 Jun 01; 32
AB  - We describe a 54-year-old woman with rheumatoid arthritis (RA), who developed acute respiratory failure 2 weeks after cessation of 6-week treatment with leflunomide. We diagnosed interstitial pneumonia, probably induced by leflunomide because acute respiratory failure was preceded by elevated serum liver enzyme concentration and hypertension. She showed dramatic improvement with prednisolone and cholestyramine. Prompt treatment may improve the prognosis. In Japan, leflunomide has been implicated as a possible cause to initiate or exacerbate interstitial pneumonia in patients with RA according to postmarketing surveillance. Clinicians should exclude pulmonary disease prior to initiating leflunomide treatment in patients with RA on the basis of a thorough history and physical examination, and chest radiograph.