title: Nonicteric liver damage with a gamma-glutamyl transpeptidase level of 5,609 units/l in a renal-transplant recipient receiving azathioprine.
abstract: A 26-year-old male with renal allograft, who received immunosuppressive treatment with azathioprine, presented marked elevations of serum biliary tract enzymes, such as gamma-glutamyl transpeptidase (5,609 units/l) and alkaline phosphatase (60.5 Bessey-Lowry units), 14 months after transplantation. Two months later the patient became icteric; he died of respiratory failure 19 months after the renal allograft. Postmortem examination revealed intrahepatic cholestasis with minimal inflammatory cell infiltration, indicating drug hepatotoxicity.
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000032:analysis; D001379:Azathioprine / Q000009:adverse effects*; D001646:Bile / Q000201:enzymology; D006801:Humans; D016030:Kidney Transplantation; D008099:Liver / Q000201:enzymology / Q000473:pathology*; D008297:Male; D013997:Time Factors; D014184:Transplantation, Homologous; D005723:gamma-Glutamyltransferase / Q000032:analysis*
chemical_list: D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001379:Azathioprine