«Метотрексатовое легкое»: взгляд на проблему сегодня


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Аннотация

Метотрексат обладает потенциальным пневмопатическим действием, являясь основным лекарственным средством для лечения ревматоидного артрита (РА). «Метотрексатовое легкое» относится к редким осложнениям терапии метотрексатом, но характеризуется достаточно высоким уровнем летальности. Диагноз метотрексатовой пневмопатии (М-пневмопатии) основывается на интеграции клинических и радиологических данных, является диагнозом исключения. В клинической практике достаточно сложно разграничить М-пневмопатию от поражения легких при РА и инфекционных осложнений без проведения детального обследования. «Триада» из метотрексата, интерстициального заболевания легких (ИЗЛ) и РА служит предметом дискуссий и разногласий на протяжении многих лет. С одной стороны, имеются данные об увеличении риска М-пневмопатии у пациентов с предшествовавшим ИЗЛ, с другой - накапливаются результаты исследований, свидетельствующих о протективном действии метотрексата в отношении риска ИЗЛ у больных РА.

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И. Н Трофименко

Иркутская государственная медицинская академия последипломного образования

Email: tin11@mail.ru
д.м.н., доцент, зав. кафедрой клинической аллергологии и пульмонологии Иркутск, Россия

Б. А Черняк

Иркутская государственная медицинская академия последипломного образования

кафедра клинической аллергологии и пульмонологии Иркутск, Россия

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