Successful Treatment of Leflunomide-Induced Acute Pneumonitis With Cholestyramine Wash-Out Therapy

Abstract

In Brief Drug-induced acute pneumonitis is a rare but potentially fatal adverse drug reaction. A high index of suspicion is needed for early diagnosis as it mimics community acquired pneumonia and interstitial lung disease that can occur in rheumatoid arthritis. We report a 32-year-old Chinese lady who suffered from leflunomide-induced pneumonitis and improved dramatically after receiving cholestyramine wash-out therapy. This case illustrates the need for clinical alertness to this potentially fatal complication. When in doubt, discontinuation of leflunomide and empirical wash-out therapy should be administered without delay. This complication is more common than originally suspected. Prompt drug discontinuation and cholestyramine washout is proposed to have been effective without corticosteroids.