In psoriasis, liver function tests, including serum albumin, should be performed periodically prior to dosing but are often normal in the face of developing fibrosis or cirrhosis. These lesions may be detectable only by biopsy. The usual recommendation is to obtain a liver biopsy at 1) pretherapy or shortly after initiation of therapy (2 to 4 months), 2) a total cumulative dose of grams, and 3) after each additional 1 to grams. Moderate fibrosis or any cirrhosis normally leads to discontinuation of the drug; mild fibrosis normally suggests a repeat biopsy in 6 months. Milder histologic findings such as fatty change and low grade portal inflammation, are relatively common pretherapy. Although these mild changes are usually not a reason to avoid or discontinue methotrexate therapy, the drug should be used with caution.
Help I have a friend who is a gym goer Im not sure of his quantity or how long he has been taking steroids, but stopped recently because he had really bad neck pain. No dr or scan, ultrasound etc showed anything. Put on huge pain killer amounts didnt help alot but felt after about six weeks some relief. Until today when he thinks a prior knee issue has flared up. If this a result of steroid abuse how long before it heals? Im pretty sure he wont touch them again. He can handle all over aches and pains but these last two injuries have had him off work.