AI Article Synopsis
- Purine analogues, such as azathioprine, are commonly used to treat inflammatory bowel diseases (IBD), but they can lead to nodular regenerative hyperplasia (NRH) of the liver.
- Four cases were reported where patients with IBD developed NRH while on azathioprine, showing liver and platelet abnormalities that improved after stopping the drug.
- Male patients may have a higher risk due to genetic factors affecting how purine analogues are metabolized, highlighting the need for clinicians to monitor for potential liver complications in these patients.
Article Abstract
Purine analogues are major drugs in the treatment of inflammatory bowel diseases (IBD). We present four cases of nodular regenerative hyperplasia of the liver (NRH) developed in patients with IBD treated with azathioprine. All patients had either abnormal liver tests and/or low platelet count. Although biochemical and hematological abnormalities regressed after azathioprine withdrawal, the long term evolution of the hepatic lesions (and the risk to develop further complications including portal hypertension) remains to be determined. Male gender seems to be a major risk factor by providing a predisposing pharmacogenetic profile of purine analogue metabolism. Clinicians should be aware of this serious complication which may occur with any of the purine analogues (azathioprine, 6-mercaptopurine, and 6-thioguanine).
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| http://dx.doi.org/10.1016/s0399-8320(05)82136-0 | DOI Listing |
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