Abstract
Methotrexate (MTX) hepatoxicity was evaluated in serial liver biopsies from 18 patients with rheumatoid arthritis receiving weekly MTX 7.5-20mg for a minimum of 12 months. Fatty change, focal necrosis, nuclear pleomorphism, Kupffer cell enlargement and hepatic fibrosis were assessed using a semiquantitative grading system; the results were compared to those obtained using a microcomputer analysis system to measure changes in hepatic collagen. Subjective assessment showed a small but significant increase in overall pathology (p<0.02) and pericellular collagen (p<0.01), while morphometry showed a significant increase in pericellular (p<0.02) perivenular (p<0.05) and portal tract (p<0.05> collagen. <h3>Conclusion</h3> Computerised morphometry offers a rapid, reliable and sensitive method for the assessment of progressive hepatic fibrosis occurring in association with MTX.
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