The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients

Lennard P L Gilissen; Rudaba Tajzai; Marielle Romberg; Marieke Pierik; Arnold Stronkhorst; Karin Steenhuisen; Ad Van Bodegraven; Alette Daniels; Dennis Wong

doi:10.1097/MEG.0000000000001980

The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients

Lennard P L Gilissen^*, Rudaba Tajzai, Marielle Romberg, Marieke Pierik, Arnold Stronkhorst, Karin Steenhuisen, Ad Van Bodegraven, Alette Daniels, Dennis Wong

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

INTRODUCTION: Nodular regenerative hyperplasia (NRH) has been associated with thiopurine therapy in patients with inflammatory bowel disease (IBD), but prevalence and prognosis of NRH remain unclear. This study is a cross-sectional search for NRH in IBD patients with long-term azathioprine or 6-mercaptopurine treatment.

MATERIAL AND METHODS: Thirty-three IBD patients with continuous azathioprine/6-mercaptopurine treatment for at least 5 years were included. Laboratory tests, thiopurine metabolite levels, liver histology, MRI were examined for NRH and signs of portal hypertension.

RESULTS: NRH was not observed in this cohort of 33 patients. Nevertheless, some possibly related signs of vascular changes were found by MRI in three patients. Also, splenomegaly, which may be associated with portal hypertension, was found in one patient. No high thiopurine dose neither high metabolite levels were found in these patients.

CONCLUSION: No NRH was found in this group of IBD patients with long-term azathioprine/6-mercaptopurine treatment. Larger multicenter studies are needed to determine the prevalence of NRH in thiopurine-treated IBD patients.

Original language	English
Pages (from-to)	e102-e107
Number of pages	6
Journal	European Journal of Gastroenterology & Hepatology
Volume	33
Issue number	1S Suppl 1
DOIs	https://doi.org/10.1097/MEG.0000000000001980
Publication status	Published - 1 Dec 2021

Keywords

hepatotoxicity
inflammatory bowel disease
nodular regenerative hyperplasia
thiopurine
LOW-DOSE 6-THIOGUANINE
IBD PATIENTS
6-MERCAPTOPURINE THERAPY
AZATHIOPRINE
THIOGUANINE
HEPATOTOXICITY
SAFETY
ASSOCIATION
INTOLERANT
TOXICITY

Access to Document

10.1097/MEG.0000000000001980

Cite this

Gilissen, L. P. L., Tajzai, R., Romberg, M., Pierik, M., Stronkhorst, A., Steenhuisen, K., Van Bodegraven, A., Daniels, A., & Wong, D. (2021). The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients. European Journal of Gastroenterology & Hepatology, 33(1S Suppl 1), e102-e107. https://doi.org/10.1097/MEG.0000000000001980

@article{5674ca8153a8477496ff28d06d8fa3d0,

title = "The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients",

abstract = "INTRODUCTION: Nodular regenerative hyperplasia (NRH) has been associated with thiopurine therapy in patients with inflammatory bowel disease (IBD), but prevalence and prognosis of NRH remain unclear. This study is a cross-sectional search for NRH in IBD patients with long-term azathioprine or 6-mercaptopurine treatment.MATERIAL AND METHODS: Thirty-three IBD patients with continuous azathioprine/6-mercaptopurine treatment for at least 5 years were included. Laboratory tests, thiopurine metabolite levels, liver histology, MRI were examined for NRH and signs of portal hypertension.RESULTS: NRH was not observed in this cohort of 33 patients. Nevertheless, some possibly related signs of vascular changes were found by MRI in three patients. Also, splenomegaly, which may be associated with portal hypertension, was found in one patient. No high thiopurine dose neither high metabolite levels were found in these patients.CONCLUSION: No NRH was found in this group of IBD patients with long-term azathioprine/6-mercaptopurine treatment. Larger multicenter studies are needed to determine the prevalence of NRH in thiopurine-treated IBD patients.",

keywords = "hepatotoxicity, inflammatory bowel disease, nodular regenerative hyperplasia, thiopurine, LOW-DOSE 6-THIOGUANINE, IBD PATIENTS, 6-MERCAPTOPURINE THERAPY, AZATHIOPRINE, THIOGUANINE, HEPATOTOXICITY, SAFETY, ASSOCIATION, INTOLERANT, TOXICITY",

author = "Gilissen, {Lennard P L} and Rudaba Tajzai and Marielle Romberg and Marieke Pierik and Arnold Stronkhorst and Karin Steenhuisen and {Van Bodegraven}, Ad and Alette Daniels and Dennis Wong",

year = "2021",

month = dec,

day = "1",

doi = "10.1097/MEG.0000000000001980",

language = "English",

volume = "33",

pages = "e102--e107",

journal = "European Journal of Gastroenterology & Hepatology",

issn = "0954-691X",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "1S Suppl 1",

}

Gilissen, LPL, Tajzai, R, Romberg, M, Pierik, M, Stronkhorst, A, Steenhuisen, K, Van Bodegraven, A, Daniels, A & Wong, D 2021, 'The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients', European Journal of Gastroenterology & Hepatology, vol. 33, no. 1S Suppl 1, pp. e102-e107. https://doi.org/10.1097/MEG.0000000000001980

The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients. / Gilissen, Lennard P L; Tajzai, Rudaba; Romberg, Marielle et al.
In: European Journal of Gastroenterology & Hepatology, Vol. 33, No. 1S Suppl 1, 01.12.2021, p. e102-e107.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The prevalence of nodular regenerative hyperplasia of the liver in long-term thiopurine-treated inflammatory bowel disease patients

AU - Gilissen, Lennard P L

AU - Tajzai, Rudaba

AU - Romberg, Marielle

AU - Pierik, Marieke

AU - Stronkhorst, Arnold

AU - Steenhuisen, Karin

AU - Van Bodegraven, Ad

AU - Daniels, Alette

AU - Wong, Dennis

PY - 2021/12/1

Y1 - 2021/12/1

N2 - INTRODUCTION: Nodular regenerative hyperplasia (NRH) has been associated with thiopurine therapy in patients with inflammatory bowel disease (IBD), but prevalence and prognosis of NRH remain unclear. This study is a cross-sectional search for NRH in IBD patients with long-term azathioprine or 6-mercaptopurine treatment.MATERIAL AND METHODS: Thirty-three IBD patients with continuous azathioprine/6-mercaptopurine treatment for at least 5 years were included. Laboratory tests, thiopurine metabolite levels, liver histology, MRI were examined for NRH and signs of portal hypertension.RESULTS: NRH was not observed in this cohort of 33 patients. Nevertheless, some possibly related signs of vascular changes were found by MRI in three patients. Also, splenomegaly, which may be associated with portal hypertension, was found in one patient. No high thiopurine dose neither high metabolite levels were found in these patients.CONCLUSION: No NRH was found in this group of IBD patients with long-term azathioprine/6-mercaptopurine treatment. Larger multicenter studies are needed to determine the prevalence of NRH in thiopurine-treated IBD patients.

AB - INTRODUCTION: Nodular regenerative hyperplasia (NRH) has been associated with thiopurine therapy in patients with inflammatory bowel disease (IBD), but prevalence and prognosis of NRH remain unclear. This study is a cross-sectional search for NRH in IBD patients with long-term azathioprine or 6-mercaptopurine treatment.MATERIAL AND METHODS: Thirty-three IBD patients with continuous azathioprine/6-mercaptopurine treatment for at least 5 years were included. Laboratory tests, thiopurine metabolite levels, liver histology, MRI were examined for NRH and signs of portal hypertension.RESULTS: NRH was not observed in this cohort of 33 patients. Nevertheless, some possibly related signs of vascular changes were found by MRI in three patients. Also, splenomegaly, which may be associated with portal hypertension, was found in one patient. No high thiopurine dose neither high metabolite levels were found in these patients.CONCLUSION: No NRH was found in this group of IBD patients with long-term azathioprine/6-mercaptopurine treatment. Larger multicenter studies are needed to determine the prevalence of NRH in thiopurine-treated IBD patients.

KW - hepatotoxicity

KW - inflammatory bowel disease

KW - nodular regenerative hyperplasia

KW - thiopurine

KW - LOW-DOSE 6-THIOGUANINE

KW - IBD PATIENTS

KW - 6-MERCAPTOPURINE THERAPY

KW - AZATHIOPRINE

KW - THIOGUANINE

KW - HEPATOTOXICITY

KW - SAFETY

KW - ASSOCIATION

KW - INTOLERANT

KW - TOXICITY

U2 - 10.1097/MEG.0000000000001980

DO - 10.1097/MEG.0000000000001980

M3 - Article

C2 - 33136726

SN - 0954-691X

VL - 33

SP - e102-e107

JO - European Journal of Gastroenterology & Hepatology

JF - European Journal of Gastroenterology & Hepatology

IS - 1S Suppl 1

ER -