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LIVER BIOPSIES FROM PSORIATICS RELATED TO METHOTREXATE THERAPY
Author(s) -
Nyfors A.
Publication year - 1977
Publication title -
acta pathologica microbiologica scandinavica section a pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0365-4184
DOI - 10.1111/j.1699-0463.1977.tb03882.x
Subject(s) - medicine , cirrhosis , methotrexate , biopsy , liver biopsy , gastroenterology , histology , confidence interval , fibrosis , cumulative dose , surgery
The purpose of this paper is to report findings in post‐MTX liver biopsies from 160 psoriatics treated with Methotrexate (MTX) in single, weekly, oral doses of 25 mg maximum. The paper comprises two materials: A. 92 patients with a single biopsy and B. 68 patients with serial biopsies. At the time of liver biopsy the 92 patients had received a mean cumulative Methotrexate dose of 2287 mg (range 50–5075 mg). One patient had cirrhosis and six patients had fibrosis. Comparing these 7 patients with patients having normal liver histology (13 patients) revealed no statistically significant difference in cumulative doses of MTX, but a statistically significant higher admitted alcohol intake during MTX therapy (p < 0.02) and an older age (p < 0.01) in the patients with cirrhosis or fibrosis. In the 68 patients MTX had accumulated to a mean dose of 3940 mg (range 325–8355 mg) at the time the latest liver biopsies were taken. Among the latest liver biopsies were 14 cirrhosis (21 per cent, 95 per cent confidence limits: 12–32 per cent) and 16 fibrosis (24 per cent, 95 per cent confidence limits: 14–35 per cent). The 14 patients with cirrhosis when compared to patients with normal histology (9 patients), had taken an equal total dose of MTX at the latest liver biopsy, but had consumed a statistically significant higher amount of alcohol (p < 0.05) during MTX therapy and also tended to be older (p < 0.06). Comparison of material A and B indicates that the prevalence of cirrhosis and fibrosis among MTX treated psoriatics increases rapidly beyond a cumultative dose of two to four grams of MTX. No MTX treated psoriatics should thus be allowed to pass this dosage range without having a liver biopsy performed.