Publication:

Methotrexate induced chronic hepatotoxicity

55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.