Article Text

Download PDFPDF

Liver histology in patients receiving low dose pulse methotrexate for the treatment of rheumatoid arthritis.
  1. R F Willkens,
  2. P A Leonard,
  3. D O Clegg,
  4. K G Tolman,
  5. J R Ward,
  6. C R Marks,
  7. M L Greene,
  8. G J Roth,
  9. C G Jackson,
  10. G W Cannon
  1. Harborview Medical Center, University of Washington, Seattle 98104.


    The liver histology of 52 patients treated with intermittent low dose pulse methotrexate for rheumatoid arthritis was evaluated using a modification of the Roenigk grading system. Patients studied had had an average of 3.2 years of treatment or had received 1.7 g methotrexate. No patient had cirrhosis; 15 (29%) patients had evidence of mild fibrosis. Histological abnormalities were not predicted by liver function test changes, with the exception that hypoalbuminaemia occurred in 60% of those with grade IV (modified criteria) findings. The need for liver biopsy in patients with rheumatoid arthritis treated with methotrexate before two years or 1500 mg of treatment has not been established. Whether serial liver biopsies will be needed beyond this time has yet to be determined.

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.