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A systematic survey evaluating 6-thioguanine-related hepatotoxicity in patients with inflammatory bowel disease
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
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2007 (English)In: Wiener Klinische Wochenschrift, ISSN 0043-5325, Vol. 119, no 17-18, 519-526 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2007. Vol. 119, no 17-18, 519-526 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-39476DOI: 10.1007/s00508-007-0841-0Local ID: 48845OAI: diva2:260325
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-01-11

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Almer, Sven
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Faculty of Health SciencesGastroenterology and HepatologyDepartment of Endocrinology and Gastroenterology UHL
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Wiener Klinische Wochenschrift
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