Detection and monitoring of methotrexate-associated lung injury using serum markers KL-6 and SP-D in rheumatoid arthritis

Intern Med. 2002 Jun;41(6):467-73. doi: 10.2169/internalmedicine.41.467.


The applicability of monitoring concentrations of serum KL-6 and serum surfactant protein-D (SP-D) in the detection of methotrexate-associated lung injury (MTX pneumonitis) in patients with rheumatoid arthritis (RA) was investigated. The concentrations of these markers, sequentially measured in two patients with RA complicated with MTX pneumonitis, were increased in accordance with the severity of MTX pneumonitis. Conversely, the concentrations of these markers were decreased with the improvement of MTX pneumonitis, suggesting that the monitoring of these markers could be applicable not only for detecting the onset of MTX pneumonitis, but also for detecting the therapeutic response of MTX pneumonitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antigens / blood*
  • Antigens, Neoplasm
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / drug therapy*
  • Biomarkers / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glucocorticoids / therapeutic use
  • Glycoproteins / blood*
  • Humans
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / drug therapy
  • Male
  • Methotrexate / adverse effects*
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Mucin-1
  • Mucins
  • Pulmonary Surfactant-Associated Protein D / blood*
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Antigens
  • Antigens, Neoplasm
  • Antirheumatic Agents
  • Biomarkers
  • Glucocorticoids
  • Glycoproteins
  • MUC1 protein, human
  • Mucin-1
  • Mucins
  • Pulmonary Surfactant-Associated Protein D
  • Methylprednisolone
  • Methotrexate