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Liver cirrhosis due to methotrexate in a patient with rheumatoid arthritis
E J ter Borg1, C A Seldenrijk, R Timmer
1Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, Netherlands.
The Netherlands Journal of Medicine
|December 1, 1996
Abstract:
A 49-year-old female with rheumatoid arthritis developed liver cirrhosis after a cumulative dosage of 6 g methotrexate (MTX). There were mild liver enzyme abnormalities, decreased liver synthesis function and possible signs of portal hypertension. After stopping MTX all laboratory abnormalities disappeared except for a mild thrombocytopenia. Risk factors and guidelines for monitoring liver toxicity during MTX treatment in rheumatoid arthritis are discussed.