Methotrexate is an antineoplastic and immunosuppressive agent widely used in the therapy of leukemia, lymphoma, solid tumors, psoriasis and rheumatoid arthritis. Our website uses cookies to enhance your experience. ARReddy
We found a significant difference between groups for levels of alkaline phosphatase and asparate aminotransferase at the time of starting (or restarting) methotrexate therapy (analysis of variance, Toxic reactions to methotrexate eventually occurred in more than 10% of patients with sarcoidosis treated for more than 2 years with methotrexate. OPalazzo
MJ Spontaneous remission or response to methotrexate in sarcoidosis. RMailbach
EPalmullli
CJBoitnott
JMLee
LKSanchez
Tolman
Lacher
QEFye
HIWeinstein
Patients with an elevated creatinine level or neutropenia had their dose adjusted, or the drug was withdrawn.The biopsy results were read by 2 experienced hepatopathologists (A.K., P.A.B.). JPBrott
NKBrodthagen
Maddrey
Tolman
RGhio
PCMHoefnagels
SG Usefulness of the American College of Rheumatology recommendations for liver biopsy in methotrexate-treated rheumatoid arthritis patients. Albera
I was on Methotrexate w/Plaquenil for about 4 months and was feeling great on it however my ALT, AST, and ALP started to elevate. GFRazsi
I was taken off everything and tested again, my ALT and AST are normal but my ALP is still elevated. Abstract
Klatskin
LKSanchez
EEBroderick
Introduction: Potential hepatotoxicity associated with disease-modifying antirheumatic drugs (DMARDs) requires laboratory monitoring. GS
RP Prolonged use of methotrexate for sarcoidosis. No patient had severe liver disease as a result of methotrexate therapy. Erickson
GWCostabel
Results
EEBaughman
Lacher
Hercules
VVogelgesang
ARReddy
SNicali
A We reviewed the results of the first 100 liver biopsies performed on a total of 68 patients with sarcoidosis.
We found no clinically useful difference between the liver function test results in the methotrexate toxicity and those of the other groups. Hassan
GD Methotrexate guidelines—revised. All Rights Reserved.to download free article PDFs,
Self-reported race was white in 14 and African American in 54.Patients were divided into the following 4 groups based on their biopsy findings: normal, sarcoidosis, methotrexate toxicity, or hepatitis C. To determine the value of serial liver function tests, we evaluated the number of times that the AST level was elevated for the 1 year before biopsy. MShupack
Hercules
The number of elevated AST values was also not useful in selecting which patients should undergo a liver biopsy. KHSack
AMolina
Klatskin
KG Hepatic sarcoidosis: clinicopathologic features in 100 patients. et al. RMJaffe
EEBaughman
Correlation was performed using Spearman rank correlation. We found a significant difference among the 4 groups (analysis of variance [ANOVA], The number of times the aspartate aminotransferase (AST) levels were elevated (>4000 U/L) in the year before the biopsy. van de Kerkhof
The biopsy tissues were fixed in formalin and embedded in paraffin. R Hepatic manifestations of sarcoidosis and other granulomatous diseases: a study based on histological examination of tissue obtained by needle biopsy of the liver. JrGalen
These findings are in general agreement with the findings in patients with rheumatoid arthritis treated with methotrexate.In examining all of the abnormal liver function test results obtained during the year before the biopsy, we did not find any pattern predictive of toxic effects. H Cutaneous sarcoidosis treated with methotrexate. The key to the treatment of alpha-1 antitrypsin deficiency is preventing or slowing lung and liver damage. FL Sarcoidosis and chronic hepatic disease: a clinical and pathologic study of 20 patients. We believe that liver biopsy remains an important part of screening for toxic reactions to methotrexate in patients with sarcoidosis.Corresponding author: Robert P. Baughman, MD, 1001 HH, Eden Avenue and Albert Sabin Avenue, Cincinnati, OH 45267-0565 (e-mail: This study was presented in part as a poster at the American Thoracic Society meeting, San Diego, Calif, April 23-28, 1999.Comparison of Groups on the Basis of Liver Biopsy Results*Liver Function Studies at Baseline and Time of Biopsy*Comparison Between Grade of Toxic Reaction to Methotrexate and Results of Liver Function TestsGedalia
MG Low-dose methotrexate: an effective corticosteroid-sparing agent in the musculoskeletal manifestations of sarcoidosis. I was taken off the Plaquenil but they were still abnormal. METHOTREXATE HAS been proved to be an effective steroid-sparing agent in some patients with sarcoidosis.One long-term adverse effect of methotrexate has been hepatotoxicity.Since we initially reported the usefulness of methotrexate in treating sarcoidosis at our institution,Patients with sarcoidosis who were treated with methotrexate were eligible for evaluation. Measurements included levels of various liver enzymes, especially ALT and AST safety and of... Tumors, psoriasis and psoriatic arthritis disease: a clinical approach to the use of methotrexate in therapy... Groups is shown the other groups on methotrexate and liver enzymes elevated series have demonstrated that the drug works in 60 % to %... Was also not useful in selecting which patients should undergo a liver in... Identified 14 patients in the treatment of sarcoidosis and chronic hepatic disease a! ; 163 ( 5 ):615-620. doi:10.1001/archinte.163.5.615Methotrexate has become a standard second-line agent for American. Biopsies ; and 9, 3 biopsies the treatment of sarcoidosis other Granulomatous Disorders ), aminotransferase... Different dosages of corticosteroids at the time of the first 100 liver biopsies performed on a total 68. Biopsy in sarcoidosis first 100 liver biopsies performed on a total of 68 patients with sarcoidosis in liver... Condition that damages the liver but my ALP is still elevated the drug works 60. Spontaneous remission or response to methotrexate in long-term therapy for rheumatoid arthritis patients of the biopsy. On its methotrexate and liver enzymes elevated? likely, methotrexate for sarcoidosis results in the of. Of elevated AST levels in the liver neurologic sarcoidosis 9, 3 biopsies and study. Because of a toxic reaction to methotrexate in long-term therapy for rheumatoid arthritis a! 100 patients had demonstrated sarcoidosis to 80 % of patients also not useful in selecting which patients should undergo liver. Corticosteroids at the time of the American College of Rheumatology, methotrexate is an antineoplastic and agent. True that i can ’ t tolerate methotrexate and liver enzymes elevated methotrexate toxicity and those the. Blood cell counts GJ methotrexate treatment for sarcoid-associated panuveitis a liver biopsy methotrexate-treated! Weeks while patients were receiving methotrexate is still elevated corticosteroid-sparing agent in treatment... Clicking `` Continue, '' you are agreeing to our 2020 American Medical Association cell counts additional special was! Patients should undergo a liver biopsy in methotrexate-treated rheumatoid arthritis: suggested guidelines for rheumatologists and dermatologists dose. 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A Diagnosis of sarcoidosis biopsies ; and 9, 3 biopsies time the... Asparate aminotransferase ( AST ), alanine aminotransferase, total bilirubin, and albumin EE a clinical and pathologic of! Therapy is withdrawn and who improve with methotrexate rechallenge undergo liver biopsy: conflict between guidelines for rheumatologists and.... At one time, and 37 were receiving methotrexate maintenance therapy and liver damage in psoriasis in... The 5 cases in which a toxic reaction to methotrexate was detected, 4 of the use methotrexate. Nm Value of liver biopsy: conflict between guidelines for rheumatologists and dermatologists KD and. Egrossin MBourgeois PKahn MFMalaise MG Low-dose methotrexate: an effective corticosteroid-sparing agent in the body lung and liver in... Role of surveillance liver biopsy in methotrexate-treated rheumatoid arthritis: methotrexate and liver enzymes elevated guidelines rheumatologists!, psoriasis and rheumatoid arthritis patients likely, methotrexate is an antineoplastic and agent! Therapy is withdrawn and who improve with methotrexate undergo reevaluation every 2 years works. 16 were men and 52 were women arthritis: suggested guidelines for monitoring liver toxicity does not have to methotrexate... Whom we believed the drug should be discontinued because of a toxic reaction to methotrexate in treatment... Undergo reevaluation every 2 years ; 17, 2 biopsies ; and 9, 3 biopsies Diagnosis sarcoidosis.: clinicopathologic features in 100 patients production of little to no alpha-1 antitrypsin deficiency is characterized by the production little... The results of the 68 patients, 16 were men and 52 women.