Pulmonary Nodulosis Associated with Leflunomide Therapy in Rheumatoid Arthritis: Report of Four Cases and Review of the Literature
Abstract
Rheumatoid arthritis (RA) is a multisystem inflammatory disease characterized by destructive synovitis and systemic
extra-articular involvement. Leflunomide is a disease-modifying anti-rheumatic drug with anti-inflammatory and antiproliferative
features. Leflunomide is an isoxazole immunomodulatory agent, which inhibits dihydroorotate dehydrogenase
enzyme involved in de novo pyrimidine synthesis. It was shown that leflunomide can reduce signs and symptoms
of rheumatoid arthritis (RA) with regression in structural damage. Pulmonary involvement is one of the extra-articular
manifestations of rheumatoid arthritis and it can occur due to either disease itself or medications used in the treatment.
We presented 4 cases with rheumatoid arthritis which developed pulmonary nodules with leflunomide therapy and
reviewed literature. J Clin Exp Invest 2016; 7 (1): 98-102
Keywords
References
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Details
Primary Language
Turkish
Subjects
Health Care Administration
Journal Section
Case Report
Publication Date
March 1, 2016
Submission Date
January 1, 2016
Acceptance Date
February 29, 2016
Published in Issue
Year 2016 Volume: 7 Number: 1