Review Article
Rheumatoid Arthritis-Associated Interstitial Lung Disease: Diagnostic Dilemma
Table 2
Common pulmonary drug toxicities and associated risk factors associated with medications used to treat rheumatoid arthritis.
| Medication | Pulmonary toxicity | Risk factors |
| NSAIDS | Noncardiogenic pulmonary edema, | High-dose treatment | Acute eosinophilic pneumonia, | | Interstitial pneumonitis | |
| Gold salts | Interstitial pneumoitis, bronchiolitis obliterans with or without organizing pneumonia, pulmonary renal syndrome, diffuse alveolar damage | Unknown, possible genetic association and cumulative ingestion >500 mg gold |
| D-penicillamine | Bronchiolitis obliterans, pulmona renal syndrome, diffuse alveolar damage | Unknown |
| Methotrexate | Acute interstitial pneumonitis, pulmonary fibrosis, pleural thickening, and chronic cough | DLCO < 70% of predicted; tobacco abuse >25 pack years; hypoalbuminemia; prior use of DMARDs; RA pleuropulmonary involvement; advanced age; diabetes mellitus |
| Anti-TNF-α biologic agents | Interstitial pneumoitis, rapidly progressive pulmonary fibrosis | Possible prior RA-ILD |
| Leflunomide | Interstitial pneumonitis | Loading dose of leflunomide; pre-existing ground glass infiltrates on HRCT |
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