Abstract
Methotrexate (MTX) therapy may be effective in patients with rheumatoid arthritis (RA) or psoriasis due to its anti-inflammatory and immunosuppressive properties. Potential liver toxicity of MTX exists, but the incidence of MTX- specific lesions in liver biopsy of patients with RA and elevated serum transaminase levels is rare; however, severe hepatic damage may occurs unexpectedly in these patients. We describe the first documented case of an adult patient with RA who developed an acute flare of severe hepatitis after long-term therapy with MTX. Autoantibodies positivity, elevated serum IgG levels and compatible liver biopsy findings prompted us to diagnose autoimmune hepatitis, most probably triggered by a breakdown of immune tolerance induced by MTX. A complete remission was achieved in this patient with corticosteroids therapy.
Keywords: Autoimmune hepatitis, methotrexate, rheumatoid arthritis, drug-induced autoimmunity, immunological tolerance, corticosteroids
Current Drug Safety
Title: Autoimmune Hepatitis After Long-Term Methotrexate Therapy for Rheumatoid Arthritis
Volume: 6 Issue: 3
Author(s): Ricardo Moreno-Otero, Luisa Garcia-Buey, Asuncion Garcia-Sanchez and Maria Trapero-Marugan
Affiliation:
Keywords: Autoimmune hepatitis, methotrexate, rheumatoid arthritis, drug-induced autoimmunity, immunological tolerance, corticosteroids
Abstract: Methotrexate (MTX) therapy may be effective in patients with rheumatoid arthritis (RA) or psoriasis due to its anti-inflammatory and immunosuppressive properties. Potential liver toxicity of MTX exists, but the incidence of MTX- specific lesions in liver biopsy of patients with RA and elevated serum transaminase levels is rare; however, severe hepatic damage may occurs unexpectedly in these patients. We describe the first documented case of an adult patient with RA who developed an acute flare of severe hepatitis after long-term therapy with MTX. Autoantibodies positivity, elevated serum IgG levels and compatible liver biopsy findings prompted us to diagnose autoimmune hepatitis, most probably triggered by a breakdown of immune tolerance induced by MTX. A complete remission was achieved in this patient with corticosteroids therapy.
Export Options
About this article
Cite this article as:
Moreno-Otero Ricardo, Garcia-Buey Luisa, Garcia-Sanchez Asuncion and Trapero-Marugan Maria, Autoimmune Hepatitis After Long-Term Methotrexate Therapy for Rheumatoid Arthritis, Current Drug Safety 2011; 6 (3) . https://dx.doi.org/10.2174/157488611797579221
DOI https://dx.doi.org/10.2174/157488611797579221 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Identification of the Active Constituents and Significant Pathways of Guizhi-Shaoyao-Zhimu Decoction for the Treatment of Diabetes Mellitus Based on Molecular Docking and Network Pharmacology
Combinatorial Chemistry & High Throughput Screening Nutraceuticals in Psychiatric Practice
Recent Patents on CNS Drug Discovery (Discontinued) Antibody Functional Assays as Measures of Fc Receptor-Mediated Immunity to HIV - New Technologies and their Impact on the HIV Vaccine Field
Current HIV Research Clinical Potential of Minocycline for Schizophrenia
CNS & Neurological Disorders - Drug Targets Quantitative Measurement of Some Physico-Chemical Parameters for the Medicinally Useful Natural Products
Letters in Drug Design & Discovery The Effects of TNF α Antagonist Therapy on Bone Metabolism in Rheumatoid Arthritis: A Systematic Review
Current Drug Targets The Holy Grail of Polymer Therapeutics for Cancer Therapy: An Overview on the Pharmacokinetics and Bio Distribution
Current Drug Metabolism Recent Advances in the Imaging of Programmed Cell Death
Current Pharmaceutical Design Anti-Degenerative Effect of Melatonin on Intervertebral Disc: Protective Contribution against Inflammation, Oxidative Stress, Apoptosis, and Autophagy
Current Drug Targets The Role of HLA Promoters in Autoimmunity
Current Pharmaceutical Design Interleukin-7: a key Mediator in T Cell-driven Autoimmunity, Inflammation, and Tissue Destruction
Current Pharmaceutical Design Fractalkine/CX3CR1 Signalling in Chronic Pain and Inflammation
Current Pharmaceutical Biotechnology Anatomical and Functional Relationships Between Sensory Nerves and Mast Cells
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Selective Neuronal Nitric Oxide Synthase Inhibitors
Current Topics in Medicinal Chemistry 5-Arylidene-4-Thiazolidinone Derivatives Active as Antidegenerative Agents on Human Chondrocyte Cultures
Medicinal Chemistry Influence of CD80 and CD86 Co-Stimulation in the Modulation of the Activation of Antigen Presenting Cells
Current Immunology Reviews (Discontinued) Therapeutic Approaches for the Management of Autoimmune Disorders via Gene Therapy: Prospects, Challenges and Opportunities
Current Gene Therapy Targeting Heat Shock Protein 90 for Malaria
Mini-Reviews in Medicinal Chemistry Emerging Trends in Endometriosis Treatment - Review
Current Women`s Health Reviews New Strategies in Evaluation of Therapeutic Efficacy in Fibromyalgia Syndrome
Current Pharmaceutical Design