Transient Elastography for Evaluating Hepatic Fibrosis in Patients Receiving Methotrexate

Abstract

Methotexate (MTX) is the drug commonly used in rheumatologic and dermatologic diseases for a long period but it has hepatotoxicity; i.e.hepatic fibrosis. Transient elastography using Fibroscan is easy, non invasive and painless. Aim: To evaluate hepatic fibrosis in patients receiving MTX by Fibroscan. Patients & Method: Transient elastography were performed in patients receiving MTX during November 2008. These patients were treated in Medical Department of Maharat Nakhon Ratchasima Hospital. Fibroscan® 502 from France with M single 3.5 MHz ultrasound probe was used to evaluate hepatic fibrosis by well trained doctors and the result is delivered at the end of the 10 acquisitions as transient elastography with record in median score (kilopascal; kPa), interquartile ratio (IQR). The results were compared with that of the normal liver stiffness 5.5+1.6 kPa. Results: Fifteen patients receiving MTX were recruited. The majority of them were female 12 patients (80.0%) and mean age 55+14 years (age range 28-71 years). Their basic diseases that needed MTX therapy were rheumatoid arthritis 80%. Their MTX data were; last dose of MTX 10.0+1.6 mg/wk (range 7.5-12.5 mg/wk), duration of MTX therapy 51.3+27.6 months (range 15-96 months) and total cumulative of MTX therapy 2.0+1.0 g (range 0.64-3.44 g). Conclusion: MTX receiving patients in Maharat Nakhon Ratchasima Hospital had normal transient elastoghaphy by Fibroscan