MTX-PNEUMO
Transparent methotrexate-associated pneumonitis risk stratification in rheumatic and autoimmune disease.
What it does
MTX-PNEUMO estimates concern for methotrexate-associated pneumonitis before methotrexate starts or while evaluating new respiratory symptoms during treatment.
Inputs
- Age and diagnosis
- Time since methotrexate initiation and weekly dose
- Pre-existing ILD/fibrosis and abnormal baseline imaging
- Prior DMARD lung toxicity
- Diabetes, hypoalbuminemia, CKD
- Dyspnea, dry cough, fever, hypoxemia
- Eosinophilia and diffuse interstitial/ground-glass pattern
- Whether infection has been excluded
Outputs
- Host vulnerability
- Exposure pattern
- Presentation severity
- Diagnostic uncertainty
- Total score and risk class
- Recommended actions, alerts, and limitations
Run
python3 mtx_pneumo.pyClinical rationale
Methotrexate pneumonitis is uncommon but potentially serious. Early fever, cough, dyspnea, hypoxemia, and diffuse infiltrates after methotrexate initiation deserve structured attention, especially in patients with reduced pulmonary reserve or baseline interstitial lung disease.
References
- Fragoulis GE, Nikiphorou E, Larsen J, Korsten P, Conway R. Front Med (Lausanne). 2019;6:238. DOI: 10.3389/fmed.2019.00238
- Conway R, Low C, Coughlan RJ, O'Donnell MJ, Carey JJ. Arthritis Rheumatol. 2014;66(4):803-812. DOI: 10.1002/art.38322
- Barrera P, Laan RF, van Riel PL, Dekhuijzen PN, Boerbooms AM, van de Putte LB. Ann Rheum Dis. 1994;53(7):434-439. DOI: 10.1136/ard.53.7.434
- Dawson JK, Graham DR, Desmond J, Fewins HE, Lynch MP. Rheumatology (Oxford). 2002;41(3):262-267. DOI: 10.1093/rheumatology/41.3.262
- Fraenkel L, Bathon JM, England BR, et al. Arthritis Rheumatol. 2021;73(7):1108-1123. DOI: 10.1002/art.41752