Methotrexate-Induced Pulmonary Fibrosis in a Patient with Rheumatoid Arthritis: A Case Report

Abstract

Methotrexate is a cornerstone in the treatment of rheumatoid arthritis (RA), offering immunosuppressive benefits that significantly reduce disease progression. However, rare adverse effects such as pulmonary fibrosis can be life-threatening. We report the case of a 66-year-old female with seropositive RA who developed progressive dyspnea and dry cough after 14 months of methotrexate therapy. Imaging and pulmonary function tests revealed restrictive lung disease, and high-resolution CT demonstrated interstitial changes consistent with drug-induced pulmonary fibrosis. Methotrexate was discontinued, and corticosteroid therapy was initiated, leading to partial symptomatic improvement. Clinicians must remain vigilant for methotrexate-induced pulmonary complications, particularly in patients presenting with new respiratory symptoms. Early recognition and intervention can mitigate irreversible damage.