Rare incidence of methotrexate-specific lesions in liver biopsy of patients with arthritis and elevated liver enzymes.

Arthritis Research & Therapy
Emilie QuintinPierre Miossec

Abstract

The present study objective was to evaluate the incidence of methotrexate (MTX)-specific liver lesions from the analysis of a liver biopsy of inflammatory arthritis patients with elevated liver enzymes. A case-control study was performed with 1,571 arthritis patients on long-term low-dose MTX therapy. Results of liver biopsy were analyzed in 41 patients with elevated liver enzymes. The expression of autoimmune markers was also assessed. This population was compared with 41 disease control subjects obtained from the same database, also on MTX but without elevated liver enzymes, matched for age, sex and rheumatic disease. Compared with the disease controls, patients with liver biopsy showed lower disease duration and lower MTX exposure, weekly and cumulative doses, reflecting shorter treatment duration due to liver abnormalities. Liver biopsies showed 17 autoimmune hepatitis-like (AIH-like) lesions, 13 nonalcoholic steatohepatitis-like lesions, seven limited liver lesions, and two primary biliary cirrhoses. However, MTX-specific lesions with dystrophic nuclei in hepatocytes were seen in only two cases. Liver biopsy lesions were associated with autoimmune markers (P = 0.007); notably, AIH-like lesions were associated with rheumato...Continue Reading

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Citations

Jul 23, 2013·Zeitschrift für Rheumatologie·W-J Mayet, A W Lohse
Jul 5, 2011·Arthritis Research & Therapy·Carlo SelmiM Eric Gershwin
Dec 21, 2012·Pharmacogenomics·Cristina Lucía Dávila-FajardoHenk-Jan Guchelaar
Oct 15, 2010·Digestive Diseases and Sciences·Carlo Selmi, Mauro Podda
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May 19, 2019·Clinical and Experimental Immunology·A Beringer, P Miossec
Apr 3, 2012·European Journal of Gastroenterology & Hepatology·Cumali EfePaolo Muratori
Apr 9, 2018·Rheumatology International·Biljana Radovanović-DinićSaša Grgov
Jun 23, 2019·Nature Reviews. Rheumatology·Audrey Beringer, Pierre Miossec
Dec 18, 2020·BMJ Case Reports·Jason WeeDan Xu

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Methods Mentioned

BETA
biopsies
biopsy

Software Mentioned

SygmaStat

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