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Rheumatology Advance Access originally published online on November 28, 2006
Rheumatology 2007 46(3):553-554; doi:10.1093/rheumatology/kel397
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Cavitating pneumonia, a severe complication of leflunomide therapy in chronic polyarthritis

G. A. W. Bruyn, T. L. Jansen, A. Ten Brinke1, M. De Vries1, P. M. Houtman and E. N. van Roon2

Department of Rheumatology, 1Department of Pulmonology and 2Department of Pharmacology, Medisch Centrum Leeuwarden, 8934 AD Leeuwarden, The Netherlands.

Correspondence to: T. L. Jansen. E-mail: t.jansen@znb.nl

The first 10% of the full text of this article appears below.

SIR, Leflunomide (LEF) selectively inhibits dihydro-orotate dehydrogenase, a key enzyme in the de novo synthesis of pyrimidines. The active metabolite, A77 1726, is a potent inhibitor of lymphocyte proliferation in vitro. LEF inhibits progression in rheumatoid (RA) and psoriatic arthritis (PsorA) [1–3]. LEF safety data have focused mainly on liver toxicity, diarrhoea, rash, alopecia and hypertension [1–3]. Unlike methotrexate (MTX), LEF was considered relatively safe for lungs. Emerging data report uncommon adverse effects including vasculitis [4, 5] and fatal . . . [Full Text of this Article]


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