Mycobacterium intracellulare Pulmonary Disease with Endobronchial Caseation in a Patient Treated with Methotrexate

• Published in: Tuberculosis and respiratory diseases Vol. 75; no. 1; pp. 28 - 31
• Main Authors: Park, Jin Sun, Jung, Eul Sik, Choi, Woosuk, Park, Soo Yong, Rim, Min Young, Yu, Inku, Park, Hyeonsu, Lee, Sang Min, Park, Jeong-Woong, Jeong, Sung Hwan, Lee, Sang Pyo, Park, Sanghui
• Format: Journal Article
• Language: Korean
• Published: 2013
• Subjects: Nontuberculous Mycobacteria; Bronchial Diseases; Arthiritis, Rheumatoid; Methotrexate; Tuberculosis, Pulmonary
• ISSN: 1738-3536; 2005-6184

Methotrexate (MTX) has been established as a standard disease-modifying anti-rheumatic drug. If adequate disease control is achieved for a reasonable period of time, tapering the MTX dosage is recommended because the chronic use of MTX can result in opportunistic infection. We present here a case of a woman with rheumatoid arthritis taking MTX, and the woman developed actively caseating endobronchial Mycobacterium intracellulare disease with pulmonary infiltrations. After discontinuing the MTX, the patient was able to tolerate 18 months of antimycobacterial treatment without flare ups of rheumatoid arthritis, and she completely recovered from nontuberculous mycobacterial respiratory disease.