To the Editor.—I read with interest the article by Moore et al1 in the January 2002 Archives entitled “Methotrexate-Related Nonnecrotizing Multifocal Axonopathy Detected by β-Amyloid Precursor Protein Immunohistochemistry.” I found the discussion of issues related to methotrexate toxicity and immunohistochemical diagnosis to be enlightening; however, I was puzzled by the reference to “hepatic granulomas consistent with chronic transfusion therapy” as part of the autopsy findings. When stated as such, the impression is that the finding and its interpretation are without question. However, it has not been my experience that chronic transfusion therapy has any relation to granulomatous disease of the liver or any other organ, nor could I find any reference to such in standard textbooks2,3 or the medical literature. Was this statement in error, or does some relationship exist between transfusion and granulomas of which I am unaware? Interestingly, methotrexate has been used successfully to treat idiopathic granulomatous hepatitis.4
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LETTERS TO THE EDITOR|
September 01 2002
Methotrexate-Related Nonnecrotizing Multifocal Axonopathy Detected by β-Amyloid Precursor Protein Immunohistochemistry Open Access
Russell S. Vega, MD
Russell S. Vega, MD
Department of Pathology University of South Florida College of Medicine James A. Haley Veterans' Affairs Hospital Tampa, FL 33612
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Arch Pathol Lab Med (2002) 126 (9): 1017.
Citation
Russell S. Vega; Methotrexate-Related Nonnecrotizing Multifocal Axonopathy Detected by β-Amyloid Precursor Protein Immunohistochemistry. Arch Pathol Lab Med 1 September 2002; 126 (9): 1017. doi: https://doi.org/10.5858/2002-126-1017a-MNMADB
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