A Diagnostic Dilemma: MTX Induced Lung Toxicity

Rachel A. Hellmann Whitaker* and Adam Shaaeli

University of Minnesota Medical School, University of Minnesota, United States of America

^*Correspondance to: Rachel A. Hellmann Whitaker 

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Abstract:

Methotrexate hypersensitivity pneumonitis is a rare diagnosis that is made through a complex series of clinical examinations, laboratory tests, and imaging. The unique case report presented herein is of an 88-year-old woman with a past medical history of polymyalgia rheumatica that was treated with methotrexate, which initially manifested as nausea and vomiting. Upon her arrival at the Emergency Department, the patient was hypoxic but denied shortness of breath or any other clinical symptoms of hypoxia. After ruling out infectious causes of pneumonia or pulmonary edema, chest computer tomography without contrast imaging on expiratory views indicated air trapping, which was suggestive of hypersensitivity pneumonitis or aspiration pneumonia. Without any acute clinical symptoms, aspiration pneumonia was ruled out, and the diagnosis of methotrexate hypersensitivity pneumonitis was made.

Keywords:

Lung Toxicity

Cite the Article:

Hellmann Whitaker RA, Shaaeli A. A Diagnostic Dilemma: MTX Induced Lung Toxicity. Ann Clin Case Rep. 2026; 11: 2844..