Liver biopsies upsilon liver scans in methotrexate-treated patients with psoriasis

The possibility of hepatotoxic reactions in 24 patients receiving long-term methotrexate therapy for psoriasis was evaluated by both liver biopsies and technetium TC 99 m sulfur-colloid liver scans. The two diagnostic methods were compared in a retrospective analysis. Six of 17 patients with clinically normal liver biopsy interpretations were found to have abnormal liver scans, while three of five patients with histologically proved fibrosis had completely normal liver scans. We conclude that hepatotoxic reactions from long-term methotrexate use in psoriasis cannot be reliably evaluated by the technetium Tc 99m sulfur colloid liver scan.