Hilsden R J, Urbanski S J, Swain M G
University of Calgary, Alberta, Canada.
Arthritis Rheum. 1995 Jul;38(7):1014-8. doi: 10.1002/art.1780380719.
We report a case of cirrhosis developing in a man who was heterozygous for alpha 1-antitrypsin deficiency and who was receiving methotrexate for severe rheumatoid arthritis. The alpha 1-antitrypsin phenotype PiMZ has been associated with cryptogenic cirrhosis. Our patient had no biochemical or histologic evidence of chronic liver disease during the first year of receiving methotrexate. We postulate that the PiMZ state may result in enhanced susceptibility to methotrexate-induced hepatic toxicity and should be screened for if liver function abnormalities occur during methotrexate therapy.
我们报告了一例患有α1-抗胰蛋白酶缺乏症杂合子的男性患者发生肝硬化的病例，该患者因严重类风湿性关节炎正在接受甲氨蝶呤治疗。α1-抗胰蛋白酶表型PiMZ与隐源性肝硬化有关。我们的患者在接受甲氨蝶呤治疗的第一年没有慢性肝病的生化或组织学证据。我们推测，PiMZ状态可能导致对甲氨蝶呤诱导的肝毒性易感性增强，如果在甲氨蝶呤治疗期间出现肝功能异常，应进行筛查。
