{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:00:32Z","timestamp":1778313632375,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":282,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Methotrexate (MTX) is the first\u2010choice disease\u2010modifying drug in juvenile idiopathic arthritis (JIA) treatment. Methotrexate is metabolized in the liver and can cause liver toxicity and fibrosis with long\u2010term use. Ultrasound shear wave elastography (SWE) is a non\u2010invasive method and can detect liver fibrosis by evaluating the liver elasticity. The aim of this study was to assess liver stiffness and detect if there is an increase in liver stiffness or fibrosis findings with the non\u2010invasive SWE method in JIA patients under MTX treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study included 49 JIA patients under MTX treatment and 48 healthy controls, matched for age and sex with a body mass index below the 95th percentile. The demographic data and clinical characteristics of patients were obtained from medical records. Liver function tests were evaluated, and liver tissue stiffness measurements were performed with SWE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 49 patients, 67.35% were girls and the mean age was 10.69 (\u00b14.33) years. The duration of MTX treatment was 23.00 (1\u201380) months, and the cumulative dose of MTX was 1,280.867 mg (\u00b1934.2) in the patient group. There was no statistically significant difference in liver stiffness between patients receiving MTX and healthy controls (<jats:italic>P<\/jats:italic> = 0.313). There was no relationship between MTX duration, cumulative dose, route of administration, and liver stiffness. Only gamma glutamyl transferase values were weakly correlated with liver stiffness (<jats:italic>P<\/jats:italic> = 0.029).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We did not detect an increase in liver tissue stiffness in JIA patients using methotrexate in comparison with controls.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.15239","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T06:48:25Z","timestamp":1652770105000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of liver elasticity with shear\u2010wave elastography in juvenile idiopathic arthritis patients receiving methotrexate"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-4413","authenticated-orcid":false,"given":"S\u00fcmeyra","family":"\u00d6zdemir \u00c7i\u00e7ek","sequence":"first","affiliation":[{"name":"Department of Pediatric Rheumatology Kayseri City Hospital  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-8098","authenticated-orcid":false,"given":"Zehra Filiz","family":"Karaman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology Erciyes University Faculty of Medicine  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-6952","authenticated-orcid":false,"given":"Nihal","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology Bursa City Hospital  Bursa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1800-9922","authenticated-orcid":false,"given":"Ay\u015fenur","family":"Pa\u00e7 K\u0131saarslan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology Erciyes University Faculty of Medicine  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5142-8432","authenticated-orcid":false,"given":"Muammer Hakan","family":"Poyrazo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology Erciyes University Faculty of Medicine  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0599-7199","authenticated-orcid":false,"given":"Ruhan","family":"D\u00fc\u015f\u00fcnsel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology Yeditepe University Faculty of Medicine  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-24145-8.00015-6"},{"key":"e_1_2_10_3_1","first-page":"2445","article-title":"Prevelance of juvenile chronic arthritis and familial Mediterranean fever in Turkey: A field study","volume":"25","author":"Ozen S","year":"1998","journal-title":"J. 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