Limited relevance and progression of histological alterations in the liver during thioguanine therapy in inflammatory bowel disease patients
| Autor: | Birgit I. Lissenberg-Witte, Joanne Verheij, Bindia Jharap, Maurice G. Russel, Elisabeth Bloemena, Dirk P. van Asseldonk, Gijsbert den Hartog, Nanne K. H. de Boer, Melek Simsek, Dik B. Westerveld, Carin M.J. van Nieuwkerk, Adriaan A. van Bodegraven, Marco C. Becx, Chris J. J. Mulder |
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| Přispěvatelé: | Gastroenterology and hepatology, AGEM - Digestive immunity, AII - Inflammatory diseases, Amsterdam Reproduction & Development (AR&D), Pathology, Epidemiology and Data Science, APH - Methodology, AGEM - Re-generation and cancer of the digestive system, Maxillofacial Surgery (VUmc) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Biopsy Gastroenterology Inflammatory bowel disease Cohort Studies 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Fibrosis Internal medicine Hypertension Portal medicine Humans Clinical significance Thioguanine Netherlands Crohn's disease medicine.diagnostic_test business.industry Middle Aged medicine.disease Inflammatory Bowel Diseases Ulcerative colitis Liver Focal Nodular Hyperplasia 030220 oncology & carcinogenesis Disease Progression Portal hypertension 030211 gastroenterology & hepatology Female Chemical and Drug Induced Liver Injury business Nodular regenerative hyperplasia |
| Zdroj: | Scandinavian Journal of Gastroenterology, 54(6), 753-760. Informa Healthcare van Asseldonk, D P, Simsek, M, de Boer, N K H, Jharap, B, Bloemena, E, den Hartog, G, Westerveld, D B, Becx, M C, Russel, M G, Lissenberg-Witte, B I, van Nieuwkerk, C M, Mulder, C J J, Verheij, J & van Bodegraven, A A 2019, ' Limited relevance and progression of histological alterations in the liver during thioguanine therapy in inflammatory bowel disease patients ', Scandinavian Journal of Gastroenterology, vol. 54, no. 6, pp. 753-760 . https://doi.org/10.1080/00365521.2019.1629006 Scandinavian journal of gastroenterology, 54(6), 753-760. Informa Healthcare |
| ISSN: | 0036-5521 |
| DOI: | 10.1080/00365521.2019.1629006 |
| Popis: | Background: Thioguanine is associated with liver toxicity, especially nodular regenerative hyperplasia (NRH). We assessed if liver histology alters during long-term maintenance treatment with thioguanine in patients with inflammatory bowel disease (IBD). Methods: Liver specimens of thioguanine treated IBD patients with at least two liver biopsies were revised by two independent liver pathologists, blinded to clinical characteristics. Alterations in histopathological findings between first and sequential liver specimen were evaluated and associated clinical data, including laboratory parameters and abdominal imaging reports, were collected. Results: Twenty-five IBD patients underwent sequential liver biopsies prior to, at time of, or after cessation of thioguanine treatment. The median time between the first and second biopsy was 25 months (range: 14–54). Except for one normal liver specimen, any degree of irregularities including inflammation, steatosis, fibrosis and some vascular disturbances were observed in the biopsies. The rates of perisinusoidal fibrosis (91%), sinusoidal dilatation (68%) and nodularity (18%) were the same in the first and second liver biopsies. A trend towards statistical significance was observed for phlebosclerosis (36% of the first vs. 68% of the second biopsies, p = .092). Presence of histopathological liver abnormalities was not associated with clinical outcomes. Furthermore, two patients in this cohort had portal hypertension in presence of phlebosclerosis. In another two patients, nodularity of the liver resolved upon thioguanine withdrawal. Conclusion: Vascular abnormalities of the liver were commonly observed in thioguanine treated IBD patients, although these were not progressive and remained of limited clinical relevance over time. |
| Databáze: | OpenAIRE |
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