Azathioprine induced liver cirrhosis An unusual side effect.docVIP

Open Journal of Gastroenterology, 2013, 3, 295-297 OJGas /10.4236/ojgas.2013.36050 Published Online October 2013 (/journal/ojgas/) Azathioprine induced liver cirrhosis: An unusual side effect Aida Ben Slama Trabelsi , Eya Hamami , Mehdi Ksiaa , Ahlem Souguir , Mohamed Ben Mabrouk , 1* 1 1 1 2 1 1 Ahlem Brahem 1 , Ali Jmaa , Salem Ajmi 1 2 Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia Department of Surgery, Sahloul Hospital, Sousse, Tunisia Email: aida.benslama@yahoo.fr * Received 14 August 2013; revised 21 September 2013; accepted 6 October 2013 Copyright ? 2013 Aida Ben Slama Trabelsi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT perisinusoidal fibrosis, hepatoportal sclerosis, and no- dular regenerative hyperplasia. In recent years, the hepatotoxic potential of thiopuri- nes, in particular 6-thioguanine (6-TG), has been dis- cussed in literature. However, cirrhosis was excep- tionally 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 dai- ly) for four years, she underwent surgical treatment for acute intestinal obstruction. In peroperative, we noticed a cirrhotic liver. A surgical biopsy was per- formed 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 iatrog