Methotrexate and A1AD caused cirrhosis

[Fluffysian]

Hello! I’ve had rheumatoid arthritis for 27 years (since I was 25) and the medication I took was methotrexate. Four years ago I had a fatty liver and was told to stop the methotrexate, loose a bit of weight and cut down drinking. I followed the advice and as far as I was aware, my liver went back to normal and liver function tests seem normal. I was never offered a follow up scan. 7 months ago, my eyes went yellow and had ascites and after many tests, scans, biopsy, etc, was found to have decompensated cirrhosis! They have said i am also a carrier of a genetic disorder called A1AD (mz genotype) and that this, and the methotrexate together have caused my liver damage. There was no evidence of any alcohol damage. I’ve heard that patients who take methotrexate now get a yearly liver scan, although others say this is only when blood tests show a problem. I had blood tests every 2 months for 27 years and the only thing that showed was elevated billirubin two months before my eyes were yellow. My alt has been slightly raised sometimes but was always ok after a repeat blood test. I’m now under Birmingham liver consultants and am waiting for assessment for transplant. Has anyone else had any adverse effects from methotrexate? Also I’d love to hear from anyone with A1AD mz that has this problem. I’m a really positive person and trying to deal with all this but it’s pretty hard sometimes!

[BritishLiverTrust4]

Hi Fluffysian

You may want to join our virtual support group for transplant patients. If so, please register through this link. britishlivertrust.org.uk/in...

[LemonMeringue15]

I'm on methotrexate and have never been offered a liver scan. In fact I had to request specific blood tests that are more accurate than LFTs, after doing some research.I'm so sorry you have been put in this position, it is totally unfair that you were prescribed medication that has had these side effects and not properly monitored.

[Positive001]

My husband is on methotrexate for polymyalgia rhumatica (PMR) He was prescribed it 5 years ago in tablet form at diagnosis, had an MRI scan of his liver and had to start having monthly blood tests to ensure the metho wasn't causing any issues with his liver. After several months a blood test revealed that it was so was taken off the metho until blood tests returned to normal. He was then prescribed it in self injection form and has had no other problems with it affecting his liver, however it has caused a blood clot... another of the wonderful side effects this drug can cause! 🙄He was offered an alternative to the metho but that has a risk of causing blindness .... take your pick ! He is continuing with the metho and puts up with the 1 day a week that he feels a bit rubbish.

I think you should give up drinking and eat healthily so that your liver has fewer poisons to deal with. You should have been monitored properly by having monthly blood tests.

Good luck.

[Hidden in reply to Positive001]

Yes, my Husband had monthly blood tests, he's now on 3 monthly blood tests. He was told this was because methotrexate can cause liver damage and they needed to keep an eye on it and catch it in the early stages.

[Positive001 in reply to Hidden]

Don't understand why they would reduce the blood tests from once a month to once every 3 months when it is essential to monitor the health of the liver. Clearly reducing the amount of blood tests has helped to contribute to the discovery of the decline in his liver.

Thankfully the care and treatment my husband has received since diagnosis has been exceptional.

So sorry you have not had the same experience.

All the best. Laura

[Hidden in reply to Positive001]

My Husband has them 3 monthly as he is very difficult to get blood from and also has been on methotrexate for over ten years so probably if he was going to show signs of a bad liver he would have by now?

[Positive001 in reply to Hidden]

Ahh l see.. well good news they are keeping check on it in the same way they are with my hubby. Seems as though others aren't and now have liver damage.

[heslinjones]

I worked offshore No alcohol for at least 6 months a year. Rheumatoid arthritis flared up and my rheumo doctor in Thailand put me on methotrexate and leftlomine. Never told me to stay off alcohol. Bloods and A scan a month later and I was given My offshore medical certificate back. A year and a half later. No liver pain just nausea and wow my first esophagal bleed . Diagnosed with cirrhosis.

My UK rheumo shook his head when he heard the cocktail of medicine I was taking. Both dangerous for the liver. Advice, always check the side effects of any medication regardless of your GP.

[Positive001 in reply to heslinjones]

Wow ! My husband was informed of all the possible side effects of all the medication he takes and has other meds to take to counteract those side effects. On blood thinners for life since the blood clot. He is never out of pain, takes painkillers which are safe for the liver and gives himself a steroid boost every few months when the pain becomes too unbearable. But if he were to stop all the meds he wouldn't be able to even get out of bed let alone continue to work and if the PMR attacked his lungs or heart (both being muscles) it could kill him. So we are grateful he is where he is.