Azathioprine induced liver disease: nodular regenerative hyperplasia of the liver and perivenous fibrosis in a patient treated for multiple sclerosis.
Azathioprine hepatotoxicity has been described mainly in renal transplant recipients. Most reported cases are related to lesions of the venous system of the liver: peliosis hepatis, veno-occlusive disease of the liver, perisinusoidal fibrosis, and nodular regenerative hyperplasia of the liver. The most common clinical manifestation of these hepatic vascular lesions is portal hypertension. We present a case of nodular regenerative hyperplasia and perivenous fibrosis in a patient receiving azathioprine for multiple sclerosis. Histological abnormalities were similar to those described in renal transplant patients, and azathioprine was the only potential hepatotoxic agent present.
Mion
F
F
Department of Gastroenterology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
Napoleon
B
B
Berger
F
F
Chevallier
M
M
Bonvoisin
S
S
Descos
L
L
D000328:Adult; D001379:Azathioprine / Q000009:adverse effects*; D006801:Humans; D006965:Hyperplasia / Q000139:chemically induced; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*
D001379:Azathioprine