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The Korean Journal of Pathology 1994;28(2): 168-172.
Methotrexate Induced Chronic Active Hepatitis: A report of two cases.
Jee Young Han, Young Nyun Park, Chan Il Park, Chae Yoon Chon
1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Although methotrexate(MTX) has been known to have many side effects, especially toxicity on the hemopoietic cells and the liver, it has been used as a potent anticancer drug and for the treatment of psoriasis or rheumatoid arthritis. The severity of hepatotoxicity varies from mild fatty change to chronic active hepatitis(CAH) and cirrhosis. We experienced two cases of MTXinduced CAH in patients with psoriasis, which prompted us to report in view of the absence of biopsy proven MTX hepatotoxicity in the Korean literature. Microscopically, the liver showed a distorted lobular architecture with portal fibrous expansion, piecemeal necrosis and bridging necrosis/fibrosis. The hepatic lobules revealed fatty changes of hepatocyte, focal hepatocytolysis, delicate collagen deposits along the space of Disse and the characteristically marked polyploid nuclear change of hepatocytes.
Key Words: Methotrexate; Hepatotoxicity; Chronic active hepatitis; Cirrhosis; Psoriasis