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We report a case of a 65\u2010year\u2010old male with long\u2010standing RA who developed multiple cavitary pulmonary nodules following prolonged leflunomide therapy. Diagnostic evaluation excluded infectious, neoplastic, and autoimmune causes. Bronchoscopy and biopsy confirmed an acute suppurative inflammatory process with central necrosis. Discontinuation of leflunomide resulted in the resolution of pulmonary nodules. This case highlights the need for vigilance regarding potential pulmonary toxicity in RA patients receiving leflunomide and underscores the importance of prompt recognition and management of drug\u2010induced complications.<\/jats:p>","DOI":"10.1002\/ccr3.9615","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T06:48:28Z","timestamp":1735541308000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pulmonary Nodules After Leflunomide Therapy in Rheumatoid Arthritis: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7008-3433","authenticated-orcid":false,"given":"Mahdiye","family":"Abiyarghamsari","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Shahid Beheshti University of Medical Sciences  Tehran Iran"},{"name":"Department of Internal Medicines Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arman","family":"Ahmadzadeh","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2021.12.002"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/cbdd.14015"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reumae.2012.06.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2015.55831"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40574"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-37132015000004247"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2015.03.004"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.5799\/jcei.328697"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\u2010conference.2022.205.1_MeetingAbstracts.A1409"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16549"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290702"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15531"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080648"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10096"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20153750"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-008-9003-6"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1240-9"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-005-0024-1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.07.3587"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T03:19:36Z","timestamp":1752808776000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ccr3.9615"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9615","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,30]]},"assertion":[{"value":"2024-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9615"}}