title: Autoimmune hepatitis as an adverse effect of long-term methotrexate therapy.
abstract: Methotrexate (MTX) is one of the most commonly used medicines in the treatment of psoriatic arthritis. The drug can produce steatosis and cirrhosis. Autoimmune hepatitis is a rare and serious adverse effect. We describe the case of a 53-year-old woman who developed autoimmune hepatitis after a long-term use of MTX for psoriatic arthritis. Hepatitis was completely resolved 4 months after stopping this drug. The pathophysiologic mechanisms of a drug-induced autoimmunity are unclear and complex. This report confirms the need to monitor liver enzymes carefully in patients using long-term treatment with MTX for psoriasis or rheumatoid arthritis.
authors.affiliation: Department of Pharmacology, School of Medecine of Sfax, Tunisia.
authors.forename: Kamilia
authors.initials: K
authors.lastname: Ksouda
authors.affiliation: Department of Pharmacology, School of Medecine of Sfax, Tunisia.
authors.forename: Hanen
authors.initials: H
authors.lastname: Affes
authors.affiliation: Department of Pharmacology, School of Medecine of Sfax, Tunisia.
authors.forename: Rim
authors.initials: R
authors.lastname: Atheymen
authors.affiliation: Department of Rheumatology, CHU Hedi Chaker Sfax, Tunisia.
authors.forename: Mariem
authors.initials: M
authors.lastname: Ezzeddine
authors.affiliation: Department of Pharmacology, School of Medecine of Sfax, Tunisia.
authors.forename: Khaled
authors.initials: K
authors.lastname: Zeghal
authors.affiliation: Department of Pharmacology, School of Medecine of Sfax, Tunisia.
authors.forename: Serria
authors.initials: S
authors.lastname: Hammami
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000097:blood / Q000188:drug therapy; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000209:etiology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000209:etiology*; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011517:Prothrombin Time; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D018501:Antirheumatic Agents; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D008727:Methotrexate
keywords: Autoimmune hepatitis; drug-induced autoimmunity; methotrexate; psoriatic arthritis