Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1989 Apr;48(4):342–346. doi: 10.1136/ard.48.4.342

Azathioprine induced hepatic veno-occlusive disease in rheumatoid arthritis.

D E Lemley 1, L M DeLacy 1, L B Seeff 1, K G Ishak 1, D J Nashel 1
PMCID: PMC1003755  PMID: 2712618

Abstract

A patient with rheumatoid arthritis developed hepatic veno-occlusive disease following the use of azathioprine. Although azathioprine induced veno-occlusive disease is suspected to occur more frequently in patients with autoimmune dysfunction, it has not previously been reported as a complication of treatment in rheumatoid arthritis. The mechanism responsible for this condition remains unknown.

Full text

PDF
344

Images in this article

343Image
on p.343
344Image
on p.344

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Assini J. F., Hamilton R., Strosberg J. M. Adverse reactions to azathioprine mimicking gastroenteritis. J Rheumatol. 1986 Dec;13(6):1117–1118. [PubMed] [Google Scholar]
  2. BALL J. Rheumatoid arthritis and polyarteritis nodosa. Ann Rheum Dis. 1954 Dec;13(4):277–290. doi: 10.1136/ard.13.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cooper C., Cotton D. W., Minihane N., Cawley M. I. Azathioprine hypersensitivity manifesting as acute focal hepatocellular necrosis. J R Soc Med. 1986 Mar;79(3):171–173. doi: 10.1177/014107688607900313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DePinho R. A., Goldberg C. S., Lefkowitch J. H. Azathioprine and the liver. Evidence favoring idiosyncratic, mixed cholestatic-hepatocellular injury in humans. Gastroenterology. 1984 Jan;86(1):162–165. [PubMed] [Google Scholar]
  5. Favreau M., Tannenbaum H., Lough J. Hepatic toxicity associated with gold therapy. Ann Intern Med. 1977 Dec;87(6):717–719. doi: 10.7326/0003-4819-87-6-717. [DOI] [PubMed] [Google Scholar]
  6. Harris M., Rash R. M., Dymock I. W. Nodular, non-cirrhotic liver associated with portal hypertension in a patient with rheumatoid arthritis. J Clin Pathol. 1974 Dec;27(12):963–966. doi: 10.1136/jcp.27.12.963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hunter T., Urowitz M. B., Gordon D. A., Smythe H. A., Ogryzlo M. A. Azathioprine in rheumatoid arthritis: a long-term follow-up study. Arthritis Rheum. 1975 Jan-Feb;18(1):15–20. doi: 10.1002/art.1780180103. [DOI] [PubMed] [Google Scholar]
  8. Katzka D. A., Saul S. H., Jorkasky D., Sigal H., Reynolds J. C., Soloway R. D. Azathioprine and hepatic venocclusive disease in renal transplant patients. Gastroenterology. 1986 Feb;90(2):446–454. doi: 10.1016/0016-5085(86)90947-9. [DOI] [PubMed] [Google Scholar]
  9. Pappas S. C., Malone D. G., Rabin L., Hoofnagle J. H., Jones E. A. Hepatic veno-occlusive disease in a patient with systemic lupus erythematosus. Arthritis Rheum. 1984 Jan;27(1):104–108. doi: 10.1002/art.1780270117. [DOI] [PubMed] [Google Scholar]
  10. Paulus H. E., Williams H. J., Ward J. R., Reading J. C., Egger M. J., Coleman M. L., Samuelson C. O., Jr, Willkens R. F., Guttadauria M., Alarcón G. S. Azathioprine versus D-penicillamine in rheumatoid arthritis patients who have been treated unsuccessfully with gold. Arthritis Rheum. 1984 Jul;27(7):721–727. doi: 10.1002/art.1780270701. [DOI] [PubMed] [Google Scholar]
  11. Read A. E., Wiesner R. H., LaBrecque D. R., Tifft J. G., Mullen K. D., Sheer R. L., Petrelli M., Ricanati E. S., McCullough A. J. Hepatic veno-occlusive disease associated with renal transplantation and azathioprine therapy. Ann Intern Med. 1986 May;104(5):651–655. doi: 10.7326/0003-4819-104-5-651. [DOI] [PubMed] [Google Scholar]
  12. Rollins B. J. Hepatic veno-occlusive disease. Am J Med. 1986 Aug;81(2):297–306. doi: 10.1016/0002-9343(86)90266-4. [DOI] [PubMed] [Google Scholar]
  13. Rosenbaum J., Katz W. A., Schumacher H. R. Hepatotoxicity associated with use of D-penicillamine in rheumatoid arthritis. Ann Rheum Dis. 1980 Apr;39(2):152–154. doi: 10.1136/ard.39.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Schenker S., Olson K. N., Dunn D., Breen K. J., Combes B. Intrahepatic cholestasis due to therapy of rheumatoid arthritis. Gastroenterology. 1973 Apr;64(4):622–629. [PubMed] [Google Scholar]
  15. Stromeyer F. W., Ishak K. G. Nodular transformation (nodular "regenerative" hyperplasia) of the liver. A clinicopathologic study of 30 cases. Hum Pathol. 1981 Jan;12(1):60–71. doi: 10.1016/s0046-8177(81)80242-0. [DOI] [PubMed] [Google Scholar]
  16. Thorne C., Urowitz M. B., Wanless I., Roberts E., Blendis L. M. Liver disease in Felty's syndrome. Am J Med. 1982 Jul;73(1):35–40. doi: 10.1016/0002-9343(82)90921-4. [DOI] [PubMed] [Google Scholar]
  17. Wanless I. R., Godwin T. A., Allen F., Feder A. Nodular regenerative hyperplasia of the liver in hematologic disorders: a possible response to obliterative portal venopathy. A morphometric study of nine cases with an hypothesis on the pathogenesis. Medicine (Baltimore) 1980 Sep;59(5):367–379. [PubMed] [Google Scholar]
  18. Whaley K., Goudie R. B., Williamson J., Nuki G., Dick W. C., Buchanan W. W. Liver disease in Sjögren's syndrome and rheumatoid arthritis. Lancet. 1970 Apr 25;1(7652):861–863. doi: 10.1016/s0140-6736(70)91690-9. [DOI] [PubMed] [Google Scholar]
  19. Woods W. G., Dehner L. P., Nesbit M. E., Krivit W., Coccia P. F., Ramsay N. K., Kim T. H., Kersey J. H. Fatal veno-occlusive disease of the liver following high dose chemotherapy, irradiation and bone marrow transplantation. Am J Med. 1980 Feb;68(2):285–290. doi: 10.1016/0002-9343(80)90368-x. [DOI] [PubMed] [Google Scholar]
  20. Zafrani E. S., von Pinaudeau Y., Dhumeaux D. Drug-induced vascular lesions of the liver. Arch Intern Med. 1983 Mar;143(3):495–502. [PubMed] [Google Scholar]
  21. Zimmerman H. J. Effects of aspirin and acetaminophen on the liver. Arch Intern Med. 1981 Feb 23;141(3 Spec No):333–342. doi: 10.1001/archinte.141.3.333. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES