Acute sinusoidal obstruction syndrome after 6-thioguanine therapy for Crohn's disease.
6-Thioguanine (6-TG), the active metabolite of 6-mercaptopurine and its prodrug azathioprine, are thought to be responsible for clinical efficacy in the treatment of active Crohn's disease. Its use as a therapeutic agent for inflammatory bowel disease (IBD) has been limited to patients who are resistant to or intolerant of other antimetabolites. Short-term experience with this agent has not demonstrated an increased incidence of hematologic or hepatic toxicity; however long-term safety data are scarce. We herein report a patient who developed acute sinusoidal obstruction syndrome after 14 months of successful thioguanine treatment. This is the first report of such a complication in an adult treated with 6-TG for active Crohn's disease.
Department of Medicine, University of Chicago, Chicago, IL 60637, USA. skane@medicine.bsd.uchicago.edu
Sunanda
S
Kane
Stanley M
SM
Cohen
John
J
Hart
D000208:Acute Disease; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced*; D006801:Humans; D008297:Male; D013577:Syndrome; D013866:Thioguanine / Q000009:adverse effects*
D000964:Antimetabolites, Antineoplastic; D013866:Thioguanine