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I. Rheumatic and Immunologic Disease: Selected Papers

Hepatotoxicity of prolonged methotrexate therapy for rheumatoid arthritis

Allen H. Mackenzie, M.D.
Cleveland Clinic Journal of Medicine June 1985, 52 (2) 129-135;
Allen H. Mackenzie
Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation
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ABSTRACT

Sixty patients with severe rheumatoid arthritis (RA), who were being treated with methotrexate (MTX) (mean duration of therapy, 48 months; mean weekly dosage, 8.67 mg), underwent liver biopsy performed to assess hepatic toxicity. Liver biopsies of 25 comparably severe RA patients not receiving MTX served as controls. All pathologic findings were grades I and II. Fatty infiltration was present in 50% of patients treated with MTX and 44% of controls. Fatty liver occurred more frequently in older patients and in consumers of alcohol. Round-cell portal inflammatory infiltrates were present in 18% of patients treated with MTX and 20% of controls, more frequently if Sjogren’s syndrome was present. No portal fibrosis (grade III) was found, but fibrous expansion of portal zones (grade II) was noted in 1 patient treated with MTX (1.7%) with Sjogren’s syndrome. At these low dosages, MTX exerts a minor and clinically unimportant hepatotoxic effect during two to eight years of chronic maintenance therapy.

Index terms
  • Arthritis
  • rheumatoid
  • drug therapy
  • Methotrexate
  • toxicity
  • Received November 1984.
  • Accepted February 1985.
  • Copyright © 1985 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 52 (2)
Cleveland Clinic Journal of Medicine
Vol. 52, Issue 2
20 Jun 1985
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Hepatotoxicity of prolonged methotrexate therapy for rheumatoid arthritis
Allen H. Mackenzie
Cleveland Clinic Journal of Medicine Jun 1985, 52 (2) 129-135;

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Hepatotoxicity of prolonged methotrexate therapy for rheumatoid arthritis
Allen H. Mackenzie
Cleveland Clinic Journal of Medicine Jun 1985, 52 (2) 129-135;
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More in this TOC Section

I. Rheumatic and Immunologic Disease: Selected Papers

  • Cryoimmunoglobulins
  • Methotrexate in rheumatoid arthritis
  • Cryotherapy
Show more I. Rheumatic and Immunologic Disease: Selected Papers

Contribution

  • Cryoimmunoglobulins
  • Methotrexate in rheumatoid arthritis
  • Cryotherapy
Show more Contribution

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Keywords

  • Arthritis
  • Rheumatoid
  • Drug Therapy
  • Methotrexate
  • toxicity

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