Hepatic failure in a patient with rheumatoid arthritis treated with methotrexate: A case report.
Medicine (Baltimore)
; 102(4): e32711, 2023 Jan 27.
Article
em En
| MEDLINE
| ID: mdl-36705384
ABSTRACT
INTRODUCTION:
Chronic liver damage from methotrexate (MTX) is not uncommon, and fatal outcome is rare. We experienced a case of hepatic failure leading to death. We considered the cause of death through this case and proposed a method to prevent the progression of this liver injury. PATIENT CONCERNS We report the case of a patient with rheumatoid arthritis treated with MTX for 15 years. DIAGNOSIS, INTERVENTIONS, ANDOUTCOMES:
A liver biopsy revealed histological changes similar to those of advanced nonalcoholic steatohepatitis (NASH), most likely induced by MTX. MTX was discontinued after 4 years. Two years after the discontinuation, the patient died of irreversible hepatic failure. Her obesity, complicated by type 2 diabetes mellitus, might have aggravated MTX-induced NASH-like liver injury.CONCLUSION:
Early diagnosis and immediate MTX discontinuation following NASH diagnosis and strict type 2 diabetes mellitus control might have prevented the irreversible progression of liver injury.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Falência Hepática
/
Antirreumáticos
/
Diabetes Mellitus Tipo 2
/
Hepatopatia Gordurosa não Alcoólica
Tipo de estudo:
Screening_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Medicine (Baltimore)
Ano de publicação:
2023
Tipo de documento:
Article