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BMC Dermatology
Published in: BMC Dermatology 1/2005

Open Access 01-12-2005 | Case report

A liver fibrosis cocktail? Psoriasis, methotrexate and genetic hemochromatosis

Authors: Joseph Mathew, May Y Leong, Nick Morley, Alastair D Burt

Published in: BMC Dermatology | Issue 1/2005

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Abstract

Background

Pathologists are often faced with the dilemma of whether to recommend continuation of methotrexate therapy for psoriasis within the context of an existing pro-fibrogenic risk factor, in this instance, patients with genetic hemochromatosis.

Case presentations

We describe our experience with two male psoriatic patients (A and B) on long term methotrexate therapy (cumulative dose A = 1.56 gms and B = 7.88 gms) with hetero- (A) and homozygous (B) genetic hemochromatosis. These patients liver function were monitored with routine biochemical profiling; apart from mild perivenular fibrosis in one patient (B), significant liver fibrosis was not identified in either patient with multiple interval percutaneous liver biopsies; in the latter instance this patient (B) had an additional risk factor of partiality to alcohol.

Conclusion

We conclude that methotrexate therapy is relatively safe in patients with genetic hemochromatosis, with no other risk factor, but caution that the risk of fibrosis be monitored, preferably by non-invasive techniques, or by liver biopsy.
Appendix
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Metadata
Title
A liver fibrosis cocktail? Psoriasis, methotrexate and genetic hemochromatosis
Authors
Joseph Mathew
May Y Leong
Nick Morley
Alastair D Burt
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Dermatology / Issue 1/2005
Electronic ISSN: 1471-5945
DOI
https://doi.org/10.1186/1471-5945-5-12

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