{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:53:18Z","timestamp":1760122398589,"version":"3.40.4"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,9,8]]},"abstract":"<jats:p>A 61-year-old woman being treated with methotrexate (MTX) 8\u201310\u2005mg\/week and prednisolone 2.5\u2005mg\/day for rheumatoid arthritis presented with a 1-week history of increasing fever and dry cough. The patient deteriorated with administration of antibiotics. Chest CT scan showed bilateral diffuse ground-glass opacities. Analysis of bronchoalveolar lavage fluid (BALF) revealed marked neutrophilia (65.2% of total cells). The specimen from transbronchial lung biopsy showed a non-specific interstitial pneumonia pattern. Following withdrawal of the MTX, her pulmonary infiltration, clinical symptoms and laboratory findings gradually improved. Therefore, she was diagnosed as having MTX-induced pneumonitis. Lymphocytosis in BALF has been identified as a characteristic of MTX-induced pneumonitis, particularly in late onset of this disease. However, the BALF in our patient was neutrophilic. Although neutrophilia in BALF of patients with drug-induced pneumonitis is usually associated with poor outcome, rare cases of good outcome do exist.<\/jats:p>","DOI":"10.1136\/bcr-2014-206123","type":"journal-article","created":{"date-parts":[[2014,9,29]],"date-time":"2014-09-29T15:51:02Z","timestamp":1412005862000},"page":"bcr2014206123","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Late-onset methotrexate-induced pneumonitis with neutrophilia in bronchoalveolar lavage fluid"],"prefix":"10.1136","volume":"2014","author":[{"given":"Hideaki","family":"Yamakawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamichi","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyoshi","family":"Kuwano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,9,29]]},"reference":[{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.91.1.96"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.7.2010120"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.52.4.377"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.7.434"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.5","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/139.1.18"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-5231(03)00143-6"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken356"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.8","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.5.9907065"},{"key":"2025042706371701000_2014.sep29_1.bcr2014206123.9","doi-asserted-by":"crossref","unstructured":"Chiba S , Jinta T , Chohnabayashi N , et al . Bronchiolitis obliterans organising pneumonia syndrome presenting with neutrophilia in bronchoalveolar lavage fluid after breast-conserving therapy. BMJ Case Rep. Published Online: 20 Mar 2012. doi:10.1136\/bcr.09.2011.4857.","DOI":"10.1136\/bcr.09.2011.4857"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-206123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:37:23Z","timestamp":1745761043000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-206123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,29]]},"references-count":9,"alternative-id":["10.1136\/bcr-2014-206123"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-206123","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,9,29]]}}}