The canals of hering might represent a target of methotrexate hepatic toxicity

Methotrexate treatment for psoriasis is known to cause hepatic fibrosis in some patients, which might progress to cirrhosis. The fine, radiating, fibrous septa developing in this setting have a distribution that is reminiscent of the location of the canals of Hering (coH). To assess the possibility...

Full description

Saved in:
Bibliographic Details
Published inAmerican journal of clinical pathology Vol. 121; no. 3; pp. 324 - 329
Main Authors HYTIROGLOU, Prodromos, TOBIAS, Hillel, SAXENA, Romil, ABRAMIDOU, Martha, PAPADIMITRIOU, Constantine S, THEISE, Neil D
Format Journal Article
LanguageEnglish
Published Chicago, IL American Society of Clinical Pathologists 01.03.2004
Subjects
Adult
Aged
Biological and medical sciences
Female
Humans
Immunosuppressive Agents - toxicity
Investigative techniques, diagnostic techniques (general aspects)
Liver - drug effects
Liver - pathology
Male
Medical sciences
Methotrexate - toxicity
Middle Aged
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Psoriasis - drug therapy
Anatomic pathology
Target
Targeting
Digestive system
Toxicity
Canals of Hering
Liver
Fibrosis
Methotrexate
Online AccessGet full text

Cover

More Information
Summary:Methotrexate treatment for psoriasis is known to cause hepatic fibrosis in some patients, which might progress to cirrhosis. The fine, radiating, fibrous septa developing in this setting have a distribution that is reminiscent of the location of the canals of Hering (coH). To assess the possibility of fibrous obliteration of the coH in patients receiving methotrexate, we developed a staining technique by combining an immunohistochemical stain for cytokeratin 7 with a modified Masson trichrome. Sixteen biopsy specimens from 7 patients were evaluated. The biopsies had a variety of histologic changes, including steatosis, anisonucleosis, multinucleation, chronic inflammation, bile duct damage, and ductular reaction. Fibrosis was present in 13 biopsy specimens (81%) and was mild in 7, moderate in 3, and severe in 3 specimens. Compared with normal (control) liver specimens, biopsy specimensfrom patients receiving methotrexate had decreased numbers of coH (1.9 +/- 0.8 vs 5.2 +/- 1.7; P < .025). In specimens with moderate or severe fibrosis, fibrous septa sometimes extended along the coH. These findings suggest that scarring of the coH might be a consequence of the toxic effects of methotrexate.
ISSN:0002-9173
1943-7722
DOI:10.1309/5HR90TNC4Q4JRXWX