Suspected azathioprine induced liver cirrhosis: an unusual side effect.
In recent years, the hepatotoxic potential of thiopurines, in particular 6-thioguanine (6-TG) has been discussed in literature. However, cirrhosis was exceptionally reported. We report the case of a 56-year-old woman with ileocaecal Crohn's disease treated with azathioprine. After taking azathioprine (2 mg/kg daily) for four years, she underwent surgical treatment for acute intestinal obstruction. In peroperative, we noticed a cirrhotic liver. A surgical biopsy was performed and the diagnosis of cirrhosis was confirmed. Autoimmune and viral liver diseases were ruled out by laboratory parameters. Therefore, Azathioprine is believed to be the causative actor for inducing liver cirrhosis. Thus, treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle.
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Aida Ben Slama
AB
Trabelsi
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Eya
E
Hamami
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Ahlem
A
Souguir
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Mehdi
M
Ksiaa
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Salem
S
Ajmi
Department of Gastroenterology, Sahloul Sousse, Tunisia.
Ali
A
Jmaa
D001379:Azathioprine / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000139:chemically induced*; D008875:Middle Aged
D007166:Immunosuppressive Agents; D001379:Azathioprine
Azathioprine; Crohn′s disease; hepatotoxicity; liver cirrhosis