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Methotrexate Hepatotoxicity in Children with Juvenile Idiopathic Arthritis: A Single-Center Study

Noha Adel Yassin1, Mai Haroon1, Azza Elhamshary1

  • 1Department of Pediatrics, Cairo University, Cairo, Egypt.

Current Rheumatology Reviews
|December 14, 2020
PubMed
Abstract

Insights

Hepatotoxicity, indicated by abnormal liver enzymes, is a common adverse effect in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX). This study found a 28% incidence of liver chemistry abnormalities in JIA patients on MTX.

Area of Science:

  • Pediatric Rheumatology
  • Hepatology
  • Pharmacology

Background:

  • Juvenile idiopathic arthritis (JIA) is a potentially disabling condition requiring effective management.
  • Methotrexate (MTX) is a primary treatment for JIA, but its use can be limited by adverse effects.
  • Hepatotoxicity is a significant concern associated with MTX therapy.

Purpose of the Study:

  • To determine the frequency of hepatotoxicity, defined by liver chemistry abnormalities, in pediatric patients with JIA receiving MTX.
  • To assess the incidence of elevated liver enzymes (ALT, AST) in children with JIA undergoing MTX treatment.

Main Methods:

  • An observational case-control study was conducted involving 80 children with JIA.
  • Fifty children were prescribed MTX, and their demographic, clinical, and treatment data were analyzed.
  • Hepatotoxicity was identified by at least one abnormal liver enzyme (ALT or AST) value during the study period.

Main Results:

  • The incidence of hepatotoxicity was 28%, with 14 out of 50 MTX-treated patients showing abnormalities.
  • Children on MTX exhibited significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels compared to controls.
  • No significant differences were observed in age, sex, weight, JIA type, or MTX treatment duration between groups.

Conclusions:

  • Hepatotoxicity, as indicated by liver chemistry tests, is a frequent complication in children with JIA treated with MTX.
  • Close monitoring of liver function is crucial for pediatric patients with JIA receiving methotrexate therapy.
Keywords:
JIA.Juvenile idiopathic arthritisMTXhepatotoxicitymethotrexatesingle-center study

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