Citation: Haseeb Ahmad, Mahnoor Fatima, Abid Ali, Ayesha Awan, Waqar Ahmad (2022). Effect of Methotrexate on Liver in Patient with Rheumatoid Arthritis. Saudi J Pathol Microbiol, 7(7): 289-298. 289 Saudi Journal of Pathology and Microbiology Abbreviated Key Title: Saudi J Pathol Microbiol ISSN 2518-3362 (Print) |ISSN 2518-3370 (Online) Scholars Middle East Publishers, Dubai, United Arab Emirates Journal homepage: https://saudijournals.com Original Research Article Effect of Methotrexate on Liver in Patient with Rheumatoid Arthritis Haseeb Ahmad 1* , Mahnoor Fatima 2 , Dr. Abid Ali 3 , Ayesha Awan 2 , Waqar Ahmad 2 1 Doctor of Medical Lab Sciences, Department of Laboratory and Medical Sciences, the University of Lahore, Gujrat, Pakistan 2 Senior Lecturer, Department of Laboratory and Medical Sciences, the University of Lahore, Gujrat Pakistan 3 Associate Professor, Department of Allied Health Sciences, the University of Lahore, Gujrat, Pakistan DOI: 10.36348/sjpm.2022.v07i07.007 | Received: 19.05.2022 | Accepted: 26.06.2022 | Published: 20.07.2022 *Corresponding author: Haseeb Ahmad Doctor of Medical Lab Sciences, Department of Laboratory and Medical Sciences, the University of Lahore, Gujrat, Pakistan Abstract Background: Methotrexate helps your immune system from assaulting your body's cells by calming it down. This helps to lessen the inflammation that causes rheumatoid arthritis's swollen and stiff joints, psoriasis' thickened skin, and Crohn's disease's gut damage. Because of its powerful effectiveness and safety, In the treatment of rheumatoid arthritis, methotrexate (MTX) is used as an anchor disease-modifying anti-rheumatic drug (DMARD) (RA).Although MTX aids a huge percentage of RA patients, it is not without adverse effects. When treating rheumatoid arthritis patients with the MTX, wide a variety of adverse effects, from minor to severe, can occur, leading to therapy termination. One putative harmful effect of methotrexate on the due to a local folate deficiency, there is a reduction in hepatic folate stores and toxicity. When MTX used with other medications, further research is needed to improve efficacy while reducing adverse effects. The management of MTX therapy is also reviewed, as well as options for dealing with adverse effects that may arise. Objective: The purpose of this study was to see how methotrexate affected individuals after 6 to 12 months of treatment for rheumatoid arthritis. Methods: Data was collected at the Shalamar hospital, Pakistan, between January 2021 and June 2022. Non- Probability Purposive Sample is the sampling strategy used in this investigation. Following the assignment of a study subject, the research took around 6 months to complete. After giving their informed consent, 120 patients between the ages of 30 and 50 were involved in this study. Data will be acquired using data collection technologies when an informed written permission form has been completed. Result: In this study 120 Rheumatoid Arthritis patients were studied, with 64 males (53.3%) and 56 women (46.7%) having an average age of 40 to 45 years and a range of 30 to 50 years. took part in the study, as shown in the graph (Table 3). In this study, 4 patients are 30 to 35 years old and have a percentage of (3.3%), 18 patients are 36 to 40 years old and have a percentage of (15%), another age group is 41 to 45 years old and has a percentage of (47.5%), and the last age group is 46 to 50 years old and has a percentage of (34.2%), as shown in the table (Table 2). The (Table 5) indicates the usual range of LFTs before Methotrexate, which is completely normal with no fluctuation in LFT parameters. As demonstrated in (Tables 6 and 8) where we examine the before and after effects of Methotrexate on the basis of patient immunity in 79 patients, the values of LFTs alter and become higher in comparison to normal, with a percentage of (65.8%). We compare the impact of Methotrexate on the basis of Gender using cross tabulation, which shows that LFTs were high in 41 males (67.1%) and 38 females (64.9%), as indicated in (Table 10). Finally, we compare the effect of Methotrexate on the basis of age factor as shown in (Table 11). After MTX therapy, RA patients experienced gastrointestinal side effects such as nausea, vomiting, and diarrhea, implying that MTX therapy will definitely affect the LFTs level and, most likely, according to the current study, will raise the LFTs level in blood, which will be treated promptly before further serious complications arise. A timely follow-up will be advised to all patients with consistently high LFTs levels. Conclusion: In this study, we discussed rheumatoid arthritis and the effects of methotrexate on rheumatoid arthritis patients' lives. It would appear that methotrexate is gaining popularity in the treatment of rheumatoid arthritis. Although there is risk of infection & probable cancer, the hazards are much outweighed by the potential therapeutic benefits. We also talked about R.A. diagnostic procedures. We covered the many characteristics of this autoimmune condition as well as several diagnostic approaches in this study. Keywords: Rheumatoid arthritis, Methotrexate, Adverse effects, LFTs, MXT. Copyright © 2022 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited. INTRODUCTION The antifolate metabolite methotrexate (MTX) affects DNA replication, repair, and synthesis. It has anti-inflammatory and immunological modulatory properties, and it was first used for the treatment of RA and psoriasis in 1951. Chronic systemic inflammation, synovial hyperplasia, and cartilage/bone degeneration characterize rheumatoid arthritis (RA), which causes temporary or permanent disability, early death, and major socioeconomic burdens. Regrettably, the underlying cause of RA is still unclear. In the etiology of RA, genetic, environmental, immunological, hormonal, and viral factors all play a role, with immune system activation being the most critical factor in disease development. While there is currently no cure