title: [Not Available].
abstract: When a patient taking methotrexate should have a liver biopsy to assess for liver damage is a difficult and critical question for rheumatologists. It is not cost effective nor medically necessary to perform biopsies on all patients after a specific dose of methotrexate has been reached, nor after they have been treated for a definite length of time. Clinicians should take into account a patient's possible pre-existing factors (hepatitis, diabetes, obesity, past and present alcohol consumption), concomitant medications, intercurrent illnesses and serial laboratory evaluations when assessing the need for a biopsy in an individual patient being treated with methotrexate.
authors.affiliation: Department of Pediatrics, Division of Immunology and Rheumatology, University of Washington, and Children's Hospital and Medical Center, Seattle, Washington, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Wallace