Poster (C14)- #STPE37 - KEYWORDS: Mosaic Attenuation, Methotrexate, Pneumocystis Jirovecii Pneumonia

Mosaic Attenuation: Methotrexate-Induced Pneumonitis or Pneumocystis Jirovecii Pneumonia in a Female with Giant Cell Arteritis

Javier Blanco Jimenez, Christian Toquica, Suyansh Sharma, Yuntao Zou
Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School/Saint Peter's University Hospital

ABSTRACT:
Methotrexate-induced pneumonitis is a rare, unpredictable and serious adverse effect of methotrexate treatment. The most common symptoms involve dyspnea, fever and cough. Chest radiographic findings range from normal to diffuse infiltrates, including interstitial, alveolar and mosaic patterns. Computed tomography frequently shows heterogeneous ground glass opacities and in some cases fibrosis. There is no definitive diagnostic test, therefore diagnosis is based on history of exposure, absence of infection, radiographic findings and histopathology if available. Treatment involves discontinuation of the offending agent, oxygen support and empirical antibiotics as patients are usually in immunocompromised state.