Methotrexate pneumonitis in a psoriatic.

A life-threatening respiratory disease, characterized by fever, cough, dyspnoea, cyanosis and wide-spread bilateral pulmonary infiltrates, developed in a 40-year-old patient receiving intermittent methotrexate therapy for psoriasis. Blood eosinophilia accompanied the illness. A prominent feature in the clinical picture was a discrepancy between auscultatory findings and the pronounced changes in the chest X-ray. Systemic corticosteroids produced rapid improvement. It is suggested that the pulmonary syndrome represents a hypersensitivity reaction.