Background: Pneumonitis is a serious and unpredictable side-effect of treatment with methotrexate (MTX) that may result in a life-threatening outcome. Pulmonary toxicity of methotrexate in patients with a gestational trophoblastic neoplasm (GTN) has rarely been reported before.
Case reports: For the first time two cases of methotrexate-induced pneumonitis and pleurisy in GTN patients of Chinese ethnicity are presented. Two patients were both categorized as the low-risk group, and underwent a single regimen therapy of methotrexate. Their symptoms, such as fever, chest pain, acute nonproductive cough, dyspnea and hypoxemia did not respond to antibiotics immediately. Treatment with corticosteroids may be helpful.
Conclusion: Awareness of pneumonitis and pleurisy, potentially life-threatening complications of MTX, is very necessary and important to early recognition and treatment.