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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
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  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • ABAT Exceptional Service Award
      • 2023 ABAT Board of Directors Voting
      • 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
      • Addiction Toxicology Section
      • Clinical Toxicology In Sports
      • Diversity, Equity, and Inclusion Section
      • Herbs & Dietary Supplements
      • Geriatric Toxicology
      • Occupational / Environmental
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      • Pediatric
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