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January 1975

Complications During Methotrexate Therapy for Psoriasis

Arch Dermatol. 1975;111(1):131. doi:10.1001/archderm.1975.01630130133027

To the Editor.—  Australia antigenemia (hepatitis B virus [HBV]), hepatitis, nonbacterial pneumonitis, and bone marrow suppression were detected in a 42-year-old male receiving long-term methotrexate therapy for psoriasis. The potential importance of these complications deserves a brief report, since patients on methotrexate therapy are usually carefully observed to insure that other known hepatotoxic factors are avoided.1The HBV antigen (Ag) was positive by both radioimmunoassay and complement fixation (1:256) methods. The HBV antibody was not detectable. Because HBV Ag is a hepatitisassociated factor, it should be considered as a potential complication of methotrexate therapy. However, the detection of HBV Ag may not always be indicative of liver disease, since it occurs in normal individuals.2,3 In the present case, the exact degree of hepatic involvement or the onset or duration of HBV antigenemia was unknown, since there was no biopsy or prior testing for HBV. Certainly this patient could

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