The use of antipyrine clearance to measure liver damage in psoriatic patients receiving methotrexate.

Salivary antipyrine clearance was measured in 15 patients with psoriasis receiving methotrexate and related to liver biopsy changes and routine liver function tests, to determine whether antipyrine clearance could be used as a non-invasive method for monitoring liver function. Comparison of the salivary antipyrine clearance in the methotrexate group (mean 0.51 ml/min/kg, range 0.26-0.81) with 15 matched psoriatic controls (mean 0.54 ml/min/kg, range 0.34-0.99) showed no significant difference. Liver biopsy changes were scored for fatty change, fibrosis, liver cell necrosis and portal tract infiltrate. Total liver biopsy scores correlated significantly with antipyrine clearance/kg body weight (r = -0.72, P less than 0.05). There was no significant correlation of total liver biopsy scores with the other liver function tests. Correlation of the individual liver biopsy changes and antipyrine clearance showed a significant correlation with fatty change (r = -0.75, P less than 0.01), but not with fibrosis (r = -0.53), liver cell necrosis (r = -0.54) or infiltrate (r = -0.41).