Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya6497310.26442/00403660.2021.03.200656Research ArticleMethotrexate-induced lung damage in a patient with rheumatoid arthritisPonomarevaLiubov A.ela12@yandex.ruhttps://orcid.org/0000-0002-3179-470XGurovaDaria V.ela12@yandex.ruhttps://orcid.org/0000-0001-8232-3679PopovaElena N.ela12@yandex.ruhttps://orcid.org/0000-0001-5164-4621ChebotarevaNatalia V.ela12@yandex.ruBondarenkoInna B.ela12@yandex.ruhttps://orcid.org/0000-0002-4111-1175MoiseevSergey V.ela12@yandex.ruhttps://orcid.org/0000-0002-7232-4640Sechenov First Moscow State Medical University (Sechenov University)150320219332952990804202108042021Copyright © 2021, Consilium Medicum2021<p>We herein report a case of interstitial lung disease secondary to the use of methotrexate in a patient with rheumatoid arthritis. Differential diagnosis between pneumonitis caused by methotrexate in patients treated with basic methotrexate therapy and interstitial pulmonary disease associated with rheumatoid arthritis is based on the clinical examination and instrumental data. The main condition for favorable clinical outcome in all drug-induced lung disease is drug withdrawal, what was proven in our report.</p>methotrexaterheumatoid arthritispulmonary fibrosisdrug-induced lung diseaseметотрексатревматоидный артритлегочный фиброзлекарственно-индуцированные поражения легких[Marcellino K, Kelly WN. Potential risks and prevention. Part 3: Drug-induced threats to life. Am J Health Syst Pharm. 2001;58(15):1399-405. doi: 10.1093/ajhp/58.15.1399][Thickett DR, Millar AB. Drug-induced antisynthetase syndrome. Postgrad Med J. 1997;73(857):165-6. doi: 10.1136/pgmj.73.857.165][Lengyel C, Boros I, Várkonyi T, et al. Amiodarone-induced pulmonary fibrosis. Orv Hetil. 1996;137(32):1759-62.][Fauroux B, Clément A, Tournier G. Pulmonary toxicity of drugs and thoracic irradiation in children. Rev Mal Respir. 1996;13(3):235-42.][Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update [published online ahead of print, 2020 Jan 22]. Ann Rheum Dis. 2020; annrheumdis-2019-216655. doi: 10.1136/annrheumdis-2019-216655][Weinblatt ME. Methotrexate in rheumatoid arthritis: a quarter century of development. Trans Am Clin Climatol Assoc. 2013;124:16-25.][Doyle TJ, Dellaripa PF. Lung Manifestations in the Rheumatic Diseases. Chest. 2017;152(6):1283-95. doi: 10.1016/j.chest.2017.05.015][Chansakul T, Dellaripa PF, Doyle TJ, Madan R. Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications. Eur J Radiol. 2015;84(10):1981-91. doi: 10.1016/j.ejrad.2015.07.008][Roubille C, Haraoui B. 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