Rheumatoid Arthritis with methotrexate and prednisone

She developed a flare-up, so methotrexate was started nine months before she was admitted to the hospital, and naproxen was discontinued. The patient had had rheumatoid arthritis for 34 years and was maintained on naproxen and on prednisone , but was unresponsive to gold therapy. A case is reported of a 71-year-old woman who was receiving weekly treatments of methotrexate and who succumbed to pneumonia caused by Nocardia, a type of bacteria known to be highly infective in patients with deficient immune systems. Although serious side effects have occurred in these and other patients treated with the drug, its use is considered to be generally safe, as severe complications are rare. Low-dose methotrexate is frequently used to treat patients with rheumatoid arthritis who are unresponsive to other medications. Abstracts: Nocardia asteroides pneumonia complicating low dose methotrexate treatment of refractory rheumatoid arthritis.