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Primary Biliary Cirrhosis Treated with Low-Dose Oral Pulse Methotrexate

Marshall M. Kaplan, MD; Tamsin A. Knox, MD; and Sanjeev Arora, MD
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Grant Support: Partial support by Research Training Grant DK 07024 and Clinical Study Unit Grant RR 300054 from the National Institutes of Health.

Requests for Reprints: Marshall M. Kaplan, MD, Gastroenterology Division, Box 233, New England Medical Center Hospitals, 750 Washington Street, Boston, MA 02111.

Current Author Addresses: Drs. Kaplan and Knox: Gastroenterology Division, Box 233, New England Medical Center Hospitals, 750 Washington Street, Boston, MA 02111.

Dr. Arora: Gastroenterology Division, Box 239, New England Medical Center Hospitals, 750 Washington Street, Boston, MA 02111.

Ann Intern Med. 1988;109(5):429-431. doi:10.7326/0003-4819-109-5-429
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This excerpt has been provided in the absence of an abstract.

There is no totally effective treatment for primary biliary cirrhosis, a chronic, progressive liver disease that most often affects middle-aged women (1). Patients treated with colchicine show improved results on biochemical tests of liver function, and colchicine appears to slow the progression of this disease, but it does not improve symptoms or liver histology (2, 3). We recently reported (4) that low-dose oral pulse methotrexate produced clinical, biochemical, and histologic remission in two patients with primary sclerosing cholangitis. Because there are clinical and immunologic similarities between primary sclerosing cholangitis and primary biliary cirrhosis (5), we studied two women with symptomatic


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