The case of methotrexate and the lung: Dr Jekyll and Mr Hyde

Involvement of the respiratory system, the commonest extra-articular manifestation of rheumatoid arthritis (RA), occurs to some extent in a large proportion of patients with RA. Any of the pulmonary compartments can be affected, either secondary to RA itself, or in relation to drug toxicity or opportunistic infection [1]. RA-associated interstitial lung disease (RA-ILD) is an increasingly recognised complication of RA, in many ways similar to …