Spontaneous Remission or Response to Methotrexate in Sarcoidosis

Abstract

A patient with sarcoidosis could not be controlled with prednisone alone. Six months of additional intermittent intravenous vinblastine therapy had no effect on the course of the disease. When biweekly oral methotrexate therapy was added to the prednisone therapy, the peripheral and mediastinal adenopathy, fever, resting tachycardia, and skin lesions all receded rapidly. No toxicity was encountered. The prednisone was tapered and stopped. Methotrexate was continued, and the remission continued. The possibility that a spontaneous remission occurred simulta neously with the addition of methotrexate cannot be ruled out. The response of a single patient to methotrexate must not be acclaimed as a successful new treatment method for sarcoidosis. It does suggest that a serious clinical trial might be undertaken by those physicians with access to numerous patients with sarcoidosis.