A systematic survey evaluating 6-thioguanine-related hepatotoxicity in patients with inflammatory bowel disease

OBJECTIVE: Drug-induced liver injury was recently reported as a major complication leading to hepatic nodular regenerative hyperplasia (NRH) in patients with inflammatory bowel disease (IBD) and 6-thioguanine (6-TG) therapy. The aim of the study was to evaluate the prevalence of 6-TG-related hepatotoxicity in a large multi-centered IBD population by means of a systematic online survey. METHODS: Clinical and laboratory data, imaging techniques (sonography, CT, MRI) and histology of liver biopsies were surveyed in IBD patients treated with 6-TG. The decision on whether liver imaging and/or liver biopsy were performed was exclusively at the discretion of the investigator. RESULTS: 6-TG use was fully documented in 296 patients (median treatment duration 56 weeks, range < 1-207). Laboratory signs of drug-induced liver injury were found in 43 patients (14.5%). Liver imaging revealed pathologic results in 68/176 patients (38.6%). Liver biopsy was performed in a subset of 60 patients, using silver-reticulin staining (n = 59), NRH was considered in 16 patients (27.1%). Age was the only independent, albeit weak, risk factor for development of NRH. CONCLUSION: This large online survey confirms the strong association between 6-TG treatment and the significant risk of development of NRH in patients with IBD. The definitive diagnosis of NRH depends solely upon liver biopsy. © 2007 Springer-Verlag.

Schwab, Matthias (författare)
Hommes, Daan W (författare)
Almer, Sven,1953-Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Gastroenterologi och hepatologi,Endokrin- och magtarmmedicinska kliniken US(Swepub:liu)sveal38 (författare)
Lukas, Milan (författare)
Feichtenschlager, Thomas (författare)
Florin, Timothy (författare)
Seiderer, Julia (författare)
Petritsch, Wolfgang (författare)
Bokemeyer, Bernd (författare)
Kreisel, Wolfgang (författare)
Herrlinger, Klaus R (författare)
Knoflach, Peter (författare)
Bonaz, Bruno (författare)
Klugmann, Thomas (författare)
Herfarth, Hans (författare)
Pedarnig, Nikolaus (författare)
Reinisch, Walter (författare)
Linköpings universitetHälsouniversitetet (creator_code:org_t)

Ingår i:Wiener Klinische Wochenschrift: Springer Science and Business Media LLC119:17-18, s. 519-5260043-53251613-7671

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