Hepatic ultrastructure after methotrexate therapy for rheumatoid arthritis

Twenty‐six patients receiving long‐term oral methotrexate (MTX) therapy for rheumatoid arthritis (24 patients) or psoriasis (2 patients) were prospectively evaluated for alterations in liver morphology by light microscopy, electron microscopy, and immunofluorescence microscopy. Although only 4 MTX‐t...

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Bibliographic Details
Published in:Arthritis and rheumatism 1988-12, Vol.31 (12), p.1465-1472
Main Authors: Bjorkman, David J., Hammond, Elizabeth H., Lee, Randall G., Clegg, Daniel O., Tolman, Keith G.
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - drug therapy
Biological and medical sciences
Chemical and Drug Induced Liver Injury
Collagen - metabolism
Drug toxicity and drugs side effects treatment
Female
Humans
Liver - cytology
Liver - metabolism
Liver - ultrastructure
Liver Diseases - metabolism
Liver Diseases - pathology
Lysosomes - drug effects
Male
Medical sciences
Methotrexate - adverse effects
Methotrexate - therapeutic use
Microscopy
Microscopy, Electron
Microscopy, Fluorescence
Middle Aged
Pharmacology. Drug treatments
Prospective Studies
Toxicity: digestive system
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Summary:Twenty‐six patients receiving long‐term oral methotrexate (MTX) therapy for rheumatoid arthritis (24 patients) or psoriasis (2 patients) were prospectively evaluated for alterations in liver morphology by light microscopy, electron microscopy, and immunofluorescence microscopy. Although only 4 MTX‐treated patients had light microscopic evidence of mild fibrosis, all had evidence of collagen deposition in the space of Disse near Ito cells and changes in hepatocyte lysosomes on electron microscopy. These findings were absent from control livers. Fibrinogen, fibronectin, and type IV collagen were identified by immunofluorescence in both MTX‐treated patients and controls. We conclude that long‐term MTX therapy for rheumatoid arthritis is associated with alterations in hepatic ultrastructure, including collagen deposition in the space of Disse and changes in hepatocyte lysosomes.
ISSN:0004-3591
1529-0131
DOI:10.1002/art.1780311202