Leflunomide, a
disease-modifying antirheumatic drug, is effective for
rheumatoid arthritis as monotherapy or combination
therapy with
methotrexate. The most common
adverse effects are
diarrhea,
dyspepsia,
nausea,
abdominal pain,
oral ulcer, hepatotoxicity,
skin rash,
hypertension,
weight loss, and
interstitial lung disease. The occurrence of pulmonary
cryptococcosis in
leflunomide treatment has not been reported in
Korea. A 74-year-old
woman was admitted to
hospital due to asymptomatic pulmonary nodule. She was diagnosed
rheumatoid arthritis and treated with
leflunomide 5 months ago due to
treatment failure with
methotrexate,
hydroxychloroquine, and
sulfasalazine.
Chest radiograph and computed
tomography showed
solitary pulmonary nodule in her right lower
lung. Pulmonary
cryptococcosis was confirmed by
needle biopsy of
lung stained with Gomori
methenamine silver and mucicarmine. The lesion was improved after antifungal
therapy for 3 months.