Methotrexate and your Liver

[PaddyPop]

Back again.

Still tapering - 2 mg Pred and 12.5 mg Methotrexate and CRP/ESR normal but this month’s bloods show Serum ALT outside normal boundaries. Should I worry? No contact from GP yet.

[PMRpro]

What they usually do is keep monitoring to see if the increase is maintained or gets worse. There are set levels that are acceptable and it isn't always the mtx that causes it. In fact, my serum ALT was raised with PMR and probably goes up if I flare!

[John_Mills Volunteer]

It’s usually the trend the doctors look at ...but if you have concerns and need to discuss these concerns you should contact your GP and/or Consultant

[PaddyPop in reply to John_Mills]

May thanks - I’ll keep an eye on the monthly results.

[AmyS1]

Nb a haemolysised sample can cause a rise in ALT.

Normally they let it go up to twice the normal limit in people on long term MXT. Keep an eye on it.

[PaddyPop in reply to AmyS1]

Thank you for the info. I’ve googled haemolysised n it says an improperly taken sample can cause result. The blood tricked into the bottles n the nurse kept swapping bottles to make up enough blood - not sure if that could do it?

I’ll keep an eye on results - my GP hasn’t contacted me so obviously not concerned. I’m seeing my consultant at the end of the month so will discuss with him.

[treesy in reply to AmyS1]

If its a haemolysed sample it will say so and the results will not be printed, because it would be giving a false reading.

[AmyS1]

If the sample was haemolysed it will say so on the lab report. You can ask whoever you had the result from.

[PMRpro in reply to AmyS1]

Only if it is frank haemolysis - i.e. you can see it with the naked eye. There can be damaged cells and it not be visible.

[PaddyPop in reply to PMRpro]

GP is interested but only enough to have a telephone appointment on Friday. Should I send these results to the consultant?

[PMRpro in reply to PaddyPop]

I don't know how your system works - I would expect a GP to notify the specialist of relevant results - or have said the specialist was also to get a report. I'd ask the GP.

[PaddyPop in reply to PMRpro]

Mmmm no my GP gives me the results to send to the consultant! The Friday telephone appt is Friday 15th Nov so I’ll email my consultants secretary n ask her to forward them to him - this is what I have done in the past.

The blood sample was haemolysed because they could not get a result for the AST serum level. Lymphocyte out of range slightly too - last time this happened, he reduced the Methotrexate.

Thank you so much for your info.