Autoimmune Hepatitis-Induced Cirrhosis due to Long- Term Methotrexate Therapy for Rheumatoid Arthritis

Habeeb Salameh, Jack Johnson, Kaled Diab, Hamzeh Saraireh, Shehzad N Merwat and Heather L Stevenson

Department of Internal Medicine, University of Texas Medical Branch at Galveston, USA
School of Medicine, University of Texas Medical Branch, USA
Department of Pathology, University of Texas Medical Branch at Galveston, USA

^*Correspondance to: Heather L. Stevenson 

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Abstract:

Methotrexate (MTX) is commonly used to treat rheumatoid arthritis and can adversely affect the liver. Autoimmune hepatitis (AIH) is an extremely rare manifestation of MTX induced liver disease and has only been described in two previous cases. This report describes a patient that developed AIH, incomplete cirrhosis and portal hypertension after 10 years of MTX therapy. Liver function improved after discontinuation of MTX and proper treatment. Internists, family practitioners, gastroenterologists and hepatologists should be aware of the uncommon side effects of MTX and appropriately monitor patient’s liver function tests. This will lead to earlier detection and prevention of bad clinical outcomes.

Keywords:

Methotrexate (MTX); Autoimmune hepatitis; Rheumatoid arthritis; Liver cirrhosis

Cite the Article:

Salameh H, Johnson J, Diab K, Saraireh H, Merwat SN, Stevenson HL. Autoimmune Hepatitis-Induced Cirrhosis due to Long-Term Methotrexate Therapy for Rheumatoid Arthritis. Ann Clin Case Rep. 2016; 1: 1122.