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

• Published in: European journal of gastroenterology & hepatology Vol. 33; no. 1S Suppl 1; p. e102
• Main Authors: Gilissen, Lennard P L, Tajzai, Rudaba, Romberg, Marielle, Pierik, Marieke, Stronkhorst, Arnold, Steenhuisen, Karin, Van Bodegraven, Ad, Daniels, Alette, Wong, Dennis
• Format: Journal Article
• Language: English
• Published: England 01.12.2021
• Subjects: Azathioprine - adverse effects; Chronic Disease; Cross-Sectional Studies; Humans; Hyperplasia; Hypertension, Portal - complications; Inflammatory Bowel Diseases - complications; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - epidemiology; Mercaptopurine - adverse effects; Prevalence
• DOI: 10.1097/MEG.0000000000001980

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. 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. 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. 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.