Skip to content
The American Academy of Clinical Toxicology
  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • 2022 ABAT Board of Directors Voting
      • ABAT Exceptional Service Award
      • ABAT Newsletter
      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
      • Certification Renewal Documents
      • Life Long Learning Articles (LLSA)
      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • E-Learning
      • Advanced Hazmat Life Support Training
      • MMTI Fundamentals for Front-Line Practitioners Training
      • TOXISMO Society for the Discussion of Scientific Literature
      • ToxNow
      • Webinars
        • ABAT Journal Club Webinars
        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • Fellows of AACT
    • ToxCoach Mentorship Program
    • Committees
    • Sections
      • Acute & Intensive Care
      • Clinical Toxicology In Sports
      • Diversity, Equity, and Inclusion Section
      • Herbs & Dietary Supplements
      • Geriatric Toxicology
      • Occupational / Environmental
      • Envenomations
      • Forensic
      • Pediatric
      • Weapons of Mass Destruction
      • Toxicology History
      • Radiation
      • Trainee and Student
    • Student Chapters
  • NACCT Annual Meeting
    • General Information Post-Conference
    • Sponsors
    • After the Fact CE
  • Research Grants
    • AACT Research Award
    • AACT Knowledge Translation Grant Award
    • Junior Investigator Research Grant
    • Gary S. Wasserman, DO, FAACT Memorial Pediatric Abstract Award
    • Toxicology Trainee Research Grant
    • Student and Trainee Travel Award
    • Lampe-Kunkel Memorial Award
  • Resources
    • AACT Mobile App
    • Publications
      • AACTion
      • Abstracts
      • Clinical Toxicology Journal
      • Question of the Day
      • News
      • Current Awareness in Clinical Toxicology
      • Toxicology Today
      • Out of Hospital Guidelines
    • Toxicology Information
    • Affiliated Organizations
    • Press Resources
    • Job Opportunities
    • Online Store
  • About Us
    • Mission & Strategic Plan
    • Board of Trustees
    • Our History
    • Membership
      • AACT Member Directory
    • Award Recipients
  • Join
  • Donate
  • Journal Access
The American Academy of Clinical Toxicology
Member LoginJoinContact
  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • 2022 ABAT Board of Directors Voting
      • ABAT Exceptional Service Award
      • ABAT Newsletter
      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
      • Certification Renewal Documents
      • Life Long Learning Articles (LLSA)
      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • E-Learning
      • Advanced Hazmat Life Support Training
      • MMTI Fundamentals for Front-Line Practitioners Training
      • TOXISMO Society for the Discussion of Scientific Literature
      • ToxNow
      • Webinars
        • ABAT Journal Club Webinars
        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • Fellows of AACT
    • ToxCoach Mentorship Program
    • Committees
    • Sections
      • Acute & Intensive Care
      • Clinical Toxicology In Sports
      • Diversity, Equity, and Inclusion Section
      • Herbs & Dietary Supplements
      • Geriatric Toxicology
      • Occupational / Environmental
      • Envenomations
      • Forensic
      • Pediatric
      • Weapons of Mass Destruction
      • Toxicology History
      • Radiation
      • Trainee and Student
    • Student Chapters
  • NACCT Annual Meeting
    • General Information Post-Conference
    • Sponsors
    • After the Fact CE
  • Research Grants
    • AACT Research Award
    • AACT Knowledge Translation Grant Award
    • Junior Investigator Research Grant
    • Gary S. Wasserman, DO, FAACT Memorial Pediatric Abstract Award
    • Toxicology Trainee Research Grant
    • Student and Trainee Travel Award
    • Lampe-Kunkel Memorial Award
  • Resources
    • AACT Mobile App
    • Publications
      • AACTion
      • Abstracts
      • Clinical Toxicology Journal
      • Question of the Day
      • News
      • Current Awareness in Clinical Toxicology
      • Toxicology Today
      • Out of Hospital Guidelines
    • Toxicology Information
    • Affiliated Organizations
    • Press Resources
    • Job Opportunities
    • Online Store
  • About Us
    • Mission & Strategic Plan
    • Board of Trustees
    • Our History
    • Membership
      • AACT Member Directory
    • Award Recipients
March 22, 2022

Question of the Day – Tuesday, March 22, 2022

Long-term methotrexate therapy has been associated with what hepatic effects?

Long term therapy with frequent but mild elevations in serum liver enzymes. More importantly, methotrexate has been associated with development of fatty liver and hepatic fibrosis and, in rare instances, portal hypertension and symptomatic cirrhosis. Liver tests are typically normal or minimally and transiently elevated. Routine monitoring of patients with regular liver biopsies done at 1 to 2 year intervals or with cumulative methotrexate doses of 1 to 10 grams demonstrates that approximately 30% of patients develop mild-to-moderate histological abnormalities (fat, cellular unrest, mild inflammation, nuclear atypical) and 2 to 20% of patients develop some degree of hepatic fibrosis.

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Methotrexate. [Updated 2020 Feb 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548219/

Keywords: Methotrexate, hepatic fibrosis, fatty liver, cirrhosis, portal hypertension

Posted in Question Of The Day
Share this

Recent Posts

  • Question of the Day – Monday, August 8, 2022
  • Question of the Day – Friday, August 5, 2022
  • Question of the Day – Thursday, August 4, 2022
  • Question of the Day – Wednesday, August 3, 2022
  • Seeking an AACT Representative to the Scientific Liaison Coalition

Site Search

Get Involved

Volunteer for a committee, as a section chair, student chapter mentor, author Question of the Day and more!

Volunteer

Support AACT

Become a ‘Friend of the Academy’ through a tax-deductible financial contribution. Donating is just a text away!

Make a Contribution
aact-footer-logo

American Academy of Clinical Toxicology
6728 Old McLean Village Drive
McLean, VA 22101

Twitter

Privacy Policy

  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • 2022 ABAT Board of Directors Voting
      • ABAT Exceptional Service Award
      • ABAT Newsletter
      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
      • Certification Renewal Documents
      • Life Long Learning Articles (LLSA)
      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • E-Learning
      • Advanced Hazmat Life Support Training
      • MMTI Fundamentals for Front-Line Practitioners Training
      • TOXISMO Society for the Discussion of Scientific Literature
      • ToxNow
      • Webinars
        • ABAT Journal Club Webinars
        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • Fellows of AACT
    • ToxCoach Mentorship Program
    • Committees
    • Sections
      • Acute & Intensive Care
      • Clinical Toxicology In Sports
      • Diversity, Equity, and Inclusion Section
      • Herbs & Dietary Supplements
      • Geriatric Toxicology
      • Occupational / Environmental
      • Envenomations
      • Forensic
      • Pediatric
      • Weapons of Mass Destruction
      • Toxicology History
      • Radiation
      • Trainee and Student
    • Student Chapters
  • NACCT Annual Meeting
    • General Information Post-Conference
    • Sponsors
    • After the Fact CE
  • Research Grants
    • AACT Research Award
    • AACT Knowledge Translation Grant Award
    • Junior Investigator Research Grant
    • Gary S. Wasserman, DO, FAACT Memorial Pediatric Abstract Award
    • Toxicology Trainee Research Grant
    • Student and Trainee Travel Award
    • Lampe-Kunkel Memorial Award
  • Resources
    • AACT Mobile App
    • Publications
      • AACTion
      • Abstracts
      • Clinical Toxicology Journal
      • Question of the Day
      • News
      • Current Awareness in Clinical Toxicology
      • Toxicology Today
      • Out of Hospital Guidelines
    • Toxicology Information
    • Affiliated Organizations
    • Press Resources
    • Job Opportunities
    • Online Store
  • About Us
    • Mission & Strategic Plan
    • Board of Trustees
    • Our History
    • Membership
      • AACT Member Directory
    • Award Recipients

© 2022 American Academy of Clinical Toxicology | Sitemap

Website by Yoko Co

Scroll To Top