PT - JOURNAL ARTICLE AU - Pekka Lahdenne AU - Juhani Rapola AU - Heikki Ylijoki AU - Jarkko Haapasaari TI - Hepatotoxicity in patients with juvenile idiopathic arthritis receiving longterm methotrexate therapy. DP - 2002 Nov 01 TA - The Journal of Rheumatology PG - 2442--2445 VI - 29 IP - 11 4099 - http://www.jrheum.org/content/29/11/2442.short 4100 - http://www.jrheum.org/content/29/11/2442.full SO - J Rheumatol2002 Nov 01; 29 AB - OBJECTIVE: To evaluate hepatotoxicity in patients with juvenile idiopathic arthritis (JIA) receiving methotrexate (MTX) therapy with doses of 20-30 mg/m2 of body surface area. METHODS: We graded the histology of percutaneous liver biopsies from 34 patients with JIA receiving longterm (> 2.4 years) MTX therapy at the Rheumatism Foundation Hospital, Heinola, Finland, using the Roenigk classification scale. Medical records of the patients with JIA were retrospectively analyzed. RESULTS: Of 10 patients with MTX doses >/= 20 mg/m2, 4 had grade II, 5 had grade I histology, and one specimen with extensive steatosis as the only pathologic finding could not be classified. All 24 patients treated with low dose MTX had grade I histology. No specimen showed fibrosis or cirrhosis. In 2 patients with grade II histology, extensive portal tract inflammation resolved when MTX was discontinued for 6 months. CONCLUSION: Aggressive medical treatment of JIA with MTX at 20-30 mg/m2 with concomitant disease modifying antirheumatic drugs and corticosteroids may contribute to minor liver abnormalities that seem to be reversible.