Ksouda Kamilia, Affes Hanen, Atheymen Rim, Ezzeddine Mariem, Zeghal Khaled, Hammami Serria
Department of Pharmacology, School of Medecine of Sfax, Tunisia.
Department of Rheumatology, CHU Hedi Chaker Sfax, Tunisia.
Indian J Pharmacol. 2014 Nov-Dec;46(6):649-50. doi: 10.4103/0253-7613.144940.
Methotrexate (MTX) is one of the most commonly used medicines in the treatment of psoriatic arthritis. The drug can produce steatosis and cirrhosis. Autoimmune hepatitis is a rare and serious adverse effect. We describe the case of a 53-year-old woman who developed autoimmune hepatitis after a long-term use of MTX for psoriatic arthritis. Hepatitis was completely resolved 4 months after stopping this drug. The pathophysiologic mechanisms of a drug-induced autoimmunity are unclear and complex. This report confirms the need to monitor liver enzymes carefully in patients using long-term treatment with MTX for psoriasis or rheumatoid arthritis.
甲氨蝶呤（MTX）是治疗银屑病关节炎最常用的药物之一。该药物可导致脂肪变性和肝硬化。自身免疫性肝炎是一种罕见且严重的不良反应。我们描述了一例53岁女性的病例，该患者因长期使用MTX治疗银屑病关节炎而发生自身免疫性肝炎。停用该药物4个月后肝炎完全消退。药物诱导的自身免疫的病理生理机制尚不清楚且复杂。本报告证实了对长期使用MTX治疗银屑病或类风湿关节炎的患者需仔细监测肝酶的必要性。
