TITLE:
Azathioprine induced liver cirrhosis: An unusual side effect
AUTHORS:
Aida Ben Slama Trabelsi, Eya Hamami, Mehdi Ksiaa, Ahlem Souguir, Mohamed Ben Mabrouk, Ahlem Brahem, Ali Jmaa, Salem Ajmi
KEYWORDS:
Azathioprine; Crohn’s Disease; Hepatotoxicity; Liver Cirrhosis
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.3 No.6,
October
15,
2013
ABSTRACT: 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 factor for inducing liver cirrhosis. Thus, treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle.