{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:39:31Z","timestamp":1789508371928,"version":"build-2803163510"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T00:00:00Z","timestamp":1535068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Hospital Organization, Japan"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0203084","type":"journal-article","created":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T17:36:06Z","timestamp":1535132166000},"page":"e0203084","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":59,"title":["Non-alcoholic steatohepatitis-like pattern in liver biopsy of rheumatoid arthritis patients with persistent transaminitis during low-dose methotrexate treatment"],"prefix":"10.1371","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7972-4252","authenticated-orcid":true,"given":"Shunsuke","family":"Mori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Arima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigetoshi","family":"Fujiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Kamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukitaka","family":"Ueki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2018,8,24]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1136\/annrheumdis-2013-204573","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update","volume":"73","author":"JS Smolen","year":"2014","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"68","author":"JA Singh","year":"2016","journal-title":"Arthritis Rheumatol"},{"issue":"5","key":"ref3","first-page":"S179","article-title":"Methotrexate as the "anchor drug" for the treatment of early rheumatoid arthritis","volume":"21","author":"T Pincus","year":"2003","journal-title":"Clin Exp Rheumatol"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/1759720X11408635","article-title":"Methotrexate: optimizing the efficacy in rheumatoid arthritis","volume":"3","author":"J Braun","year":"2011","journal-title":"Ther Adv Musculoskelet Dis"},{"issue":"Suppl 4","key":"ref5","first-page":"iv27","article-title":"Lessons for the use of non-biologic anchor treatments for rheumatoid arthritis in the era of biologic therapies","volume":"51","author":"JW Jacobs","year":"2012","journal-title":"Rheumatology (Oxford)"},{"issue":"3","key":"ref6","first-page":"316","article-title":"Methotrexate for rheumatoid arthritis. Suggested guidelines for monitoring liver toxicity. American College of Rheumatology","volume":"37","author":"JM Kremer","year":"1994","journal-title":"Arthritis Rheum"},{"issue":"6","key":"ref7","first-page":"1017","article-title":"Risk and management of liver toxicity during methotrexate treatment in rheumatoid and psoriatic arthritis: a systematic review of the literature","volume":"27","author":"K Visser","year":"2009","journal-title":"Clin Exp Rheumatol"},{"issue":"7","key":"ref8","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1136\/ard.2008.093690","article-title":"Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research","volume":"68","author":"C Salliot","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s00535-015-1050-7","article-title":"Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease\/nonalcoholic steatohepatitis","volume":"50","author":"S Watanabe","year":"2015","journal-title":"J Gastroenterol"},{"issue":"6","key":"ref10","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.jhep.2015.11.004","article-title":"EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease","volume":"64","year":"2016","journal-title":"J Hepatol"},{"issue":"1","key":"ref11","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"N Chalasani","year":"2018","journal-title":"Hepatology"},{"issue":"1","key":"ref12","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"ZM Younossi","year":"2016","journal-title":"Hepatology"},{"issue":"2","key":"ref13","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.cgh.2008.11.005","article-title":"Long-term follow-up of patients with nonalcoholic fatty liver","volume":"7","author":"N Rafiq","year":"2009","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"3017","DOI":"10.1007\/s10620-013-2743-5","article-title":"Predictors of all-cause mortality and liver-related mortality in patients with non-alcoholic fatty liver disease (NAFLD)","volume":"58","author":"M Stepanova","year":"2013","journal-title":"Dig Dis Sci"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1053\/j.gastro.2015.04.043","article-title":"Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease","volume":"149","author":"P Angulo","year":"2015","journal-title":"Gastroenterology"},{"issue":"5","key":"ref16","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1002\/hep.29085","article-title":"Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis","volume":"65","author":"PS Dulai","year":"2017","journal-title":"Hepatology"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/hep.20734","article-title":"Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study","volume":"42","author":"G Bedogni","year":"2005","journal-title":"Hepatology"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"722","DOI":"10.7326\/0003-4819-143-10-200511150-00009","article-title":"The metabolic syndrome as a predictor of nonalcoholic fatty liver disease","volume":"143","author":"M Hamaguchi","year":"2005","journal-title":"Ann Intern Med"},{"issue":"5","key":"ref19","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.jhep.2008.11.021","article-title":"Association of serum uric acid level with non-alcoholic fatty liver disease: a cross-sectional study","volume":"50","author":"Y Li","year":"2009","journal-title":"J Hepatol"},{"issue":"6","key":"ref20","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1155\/1996\/213596","article-title":"Methotrexate hepatotoxicity in psoriatics: report of 104 patients from Nova Scotia, with analysis of risks from obesity, diabetes and alcohol consumption during long term follow-up","volume":"10","author":"DA Malatjalian","year":"1996","journal-title":"Can J Gastroenterol"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1046\/j.1440-1746.2001.02644.x","article-title":"Role of non-alcoholic steatohepatitis in methotrexate-induced liver injury","volume":"16","author":"G Langman","year":"2001","journal-title":"J Gastroenterol Hepatol"},{"issue":"5","key":"ref22","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/j.1365-2036.2006.03047.x","article-title":"Liver injury in long-term methotrexate treatment in psoriasis is relatively infrequent","volume":"24","author":"MA Berends","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"issue":"6","key":"ref23","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.jhep.2007.01.024","article-title":"Psoriasis patients with diabetes type 2 are at high risk of developing liver fibrosis during methotrexate treatment","volume":"46","author":"P Rosenberg","year":"2007","journal-title":"J Hepatol"},{"issue":"3","key":"ref24","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"FC Arnett","year":"1988","journal-title":"Arthritis Rheum"},{"issue":"9","key":"ref25","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1136\/ard.2010.138461","article-title":"2010 rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"69","author":"D Aletaha","year":"2010","journal-title":"Ann Rheum Dis"},{"issue":"12","key":"ref26","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1007\/s10067-017-3804-5","article-title":"Prevalence of and factors associated with renal dysfunction in rheumatoid arthritis patients: a cross-sectional study in community hospitals","volume":"36","author":"S Mori","year":"2017","journal-title":"Clin Rheumatol"},{"issue":"7","key":"ref27","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1136\/ard.2008.094474","article-title":"Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative","volume":"68","author":"K Visser","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"ref28","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1111\/j.1572-0241.2004.30444.x","article-title":"The prevalence of autoantibodies and autoimmune hepatitis in patients with nonalcoholic Fatty liver disease","volume":"99","author":"LA Adams","year":"2004","journal-title":"Am J Gastroenterol"},{"issue":"12","key":"ref29","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1007\/s00535-005-1711-z","article-title":"Diagnosing autoimmune hepatitis in nonalcoholic fatty liver disease: is the International Autoimmune Hepatitis Group scoring system useful?","volume":"40","author":"S Yatsuji","year":"2005","journal-title":"J Gastroenterol"},{"issue":"1","key":"ref30","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1620\/tjem.139.43","article-title":"Ultrasonographical diagnosis of fatty liver: significance of the liver-kidney contrast","volume":"139","author":"Y Yajima","year":"1983","journal-title":"Tohoku J Exp Med"},{"issue":"2","key":"ref31","first-page":"201","article-title":"Abdominal ultrasonic diagnosis in medical examinations: guidlines from the Japan Society of Ningen Dock, the Japanese Society of Gastrointestinal Cancer Screening, and the Japan Society of Ultrasonics in Medicine","volume":"42","author":"S Kumada","year":"2015","journal-title":"Jpn J Med Ultrasonics"},{"issue":"10","key":"ref32","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1097\/01.TP.0000140499.23683.0D","article-title":"Noninvasive evaluation of graft steatosis in living donor liver transplantation","volume":"78","author":"M Iwasaki","year":"2004","journal-title":"Transplantation"},{"issue":"6","key":"ref33","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0016-5085(99)70506-8","article-title":"Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity","volume":"116","author":"CA Matteoni","year":"1999","journal-title":"Gastroenterology"},{"issue":"9","key":"ref34","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1111\/j.1572-0241.1999.01377.x","article-title":"Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions","volume":"94","author":"EM Brunt","year":"1999","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"ref35","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/hep.20701","article-title":"Design and validation of a histological scoring system for nonalcoholic fatty liver disease","volume":"41","author":"DE Kleiner","year":"2005","journal-title":"Hepatology"},{"issue":"6","key":"ref36","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1002\/hep.24268","article-title":"Pathologic criteria for nonalcoholic steatohepatitis: interprotocol agreement and ability to predict liver-related mortality","volume":"53","author":"ZM Younossi","year":"2011","journal-title":"Hepatology"},{"issue":"Suppl 3","key":"ref37","doi-asserted-by":"crossref","first-page":"S509","DOI":"10.1111\/j.1872-034X.2007.00289.x","article-title":"Diagnostic criteria for autoimmune hepatitis","volume":"37","author":"AW Lohse","year":"2007","journal-title":"Hepatol Res"},{"issue":"1","key":"ref38","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/hep.22906","article-title":"Primary biliary cirrhosis","volume":"50","author":"KD Lindor","year":"2009","journal-title":"Hepatology"},{"issue":"9","key":"ref39","first-page":"1727","article-title":"Risk factors for methotrexate-induced abnormal laboratory monitoring results in patients with rheumatoid arthritis","volume":"31","author":"PD Kent","year":"2004","journal-title":"J Rheumatol"},{"issue":"5","key":"ref40","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/03009749950155454","article-title":"Elevation of serum hepatic aminotransferases during treatment of rheumatoid arthritis with low-dose methotrexate. Risk factors and response to folic acid","volume":"28","author":"Y Suzuki","year":"1999","journal-title":"Scand J Rheumatol"},{"issue":"8","key":"ref41","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1002\/acr.22294","article-title":"Identification of risk factors for elevated transaminases in methotrexate users through an electronic health record","volume":"66","author":"G Schmajuk","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"8","key":"ref42","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1111\/apt.12912","article-title":"End-stage methotrexate-related liver disease is rare and associated with features of the metabolic syndrome","volume":"40","author":"MF Dawwas","year":"2014","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"ref43","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/ard.2008.101378","article-title":"Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and\/or leflunomide","volume":"69","author":"JR Curtis","year":"2010","journal-title":"Ann Rheum Dis"},{"issue":"4","key":"ref44","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jid.2017.10.024","article-title":"Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study","volume":"138","author":"A Ogdie","year":"2018","journal-title":"J Invest Dermatol"},{"issue":"4","key":"ref45","doi-asserted-by":"crossref","first-page":"R143","DOI":"10.1186\/ar3085","article-title":"Rare incidence of methotrexate-specific lesions in liver biopsy of patients with arthritis and elevated liver enzymes","volume":"12","author":"E Quintin","year":"2010","journal-title":"Arthritis Res Ther"},{"issue":"2","key":"ref46","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0190-9622(82)80064-9","article-title":"Methotrexate guidelines\u2014revised","volume":"6","author":"HH Roenigk Jr.","year":"1982","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"ref47","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1080\/030097402320817040","article-title":"Light and electron microscopic analysis of liver biopsy samples from rheumatoid arthritis patients receiving long-term methotrexate therapy","volume":"31","author":"S Ros","year":"2002","journal-title":"Scand J Rheumatol"},{"issue":"4","key":"ref48","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1046\/j.1365-2036.2004.01819.x","article-title":"Monitoring methotrexate-induced hepatic fibrosis in patients with psoriasis: are serial liver biopsies justified?","volume":"19","author":"GP Aithal","year":"2004","journal-title":"Aliment Pharmacol Ther"},{"issue":"3","key":"ref49","first-page":"459","article-title":"Significant changes in serum AST across hepatic histological biopsy grades: prospective analysis of 3 cohorts receiving methotrexate therapy for rheumatoid arthritis","volume":"23","author":"JM Kremer","year":"1996","journal-title":"J Rheumatol"},{"issue":"8","key":"ref50","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1002\/art.1780380814","article-title":"Usefulness of the American College of Rheumatology recommendations for liver biopsy in methotrexate-treated rheumatoid arthritis patients","volume":"38","author":"AR Erickson","year":"1995","journal-title":"Arthritis Rheum"},{"issue":"6","key":"ref51","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1053\/jhep.2003.50229","article-title":"Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values","volume":"37","author":"P Mofrad","year":"2003","journal-title":"Hepatology"},{"issue":"3","key":"ref52","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1002\/hep.22429","article-title":"Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes","volume":"48","author":"AL Fracanzani","year":"2008","journal-title":"Hepatology"},{"issue":"15","key":"ref53","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.3748\/wjg.15.1863","article-title":"Non-alcoholic steatohepatitis with normal aminotransferase values","volume":"15","author":"HS Uslusoy","year":"2009","journal-title":"World J Gastroenterol"},{"issue":"9","key":"ref54","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1007\/s00535-012-0704-y","article-title":"Noninvasive scoring systems in patients with nonalcoholic fatty liver disease with normal alanine aminotransferase levels","volume":"48","author":"M Yoneda","year":"2013","journal-title":"J Gastroenterol"},{"issue":"927","key":"ref55","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1259\/bjr\/75208448","article-title":"Ultrasound evaluation of the fibrosis stage in chronic liver disease by the simultaneous use of low and high frequency probes","volume":"78","author":"T Nishiura","year":"2005","journal-title":"Br J Radiol"},{"issue":"1","key":"ref56","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1148\/radiol.2272020193","article-title":"Severe liver fibrosis or cirrhosis: accuracy of US for detection\u2014analysis of 300 cases","volume":"227","author":"A Colli","year":"2003","journal-title":"Radiology"},{"issue":"3","key":"ref57","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1053\/gast.2002.35354","article-title":"The utility of radiological imaging in nonalcoholic fatty liver disease","volume":"123","author":"S Saadeh","year":"2002","journal-title":"Gastroenterology"},{"issue":"1","key":"ref58","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1586\/17474124.2016.1099433","article-title":"Current complications and challenges in nonalcoholic steatohepatitis screening and diagnosis","volume":"10","author":"P Golabi","year":"2016","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"2","key":"ref59","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/hep.23312","article-title":"Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease","volume":"51","author":"VW Wong","year":"2010","journal-title":"Hepatology"},{"issue":"5","key":"ref60","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.dld.2007.10.019","article-title":"Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD)","volume":"40","author":"M Yoneda","year":"2008","journal-title":"Dig Liver Dis"},{"issue":"6","key":"ref61","first-page":"1029","article-title":"Prevalence and risk factors for liver fibrosis detected by transient elastography or shear wave elastography in inflammatory arthritis: a systematic review","volume":"35","author":"A Rouhi","year":"2017","journal-title":"Clin Exp Rheumatol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0203084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T15:59:24Z","timestamp":1720540764000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0203084"}},"subtitle":[],"editor":[{"given":"Pavel","family":"Strnad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2018,8,24]]},"references-count":61,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2018,8,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0203084","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,24]]}}}