Clinical Course of Nodular Regenerative Hyperplasia in Thiopurine Treated Inflammatory Bowel Disease Patients

Melek Simsek; Berrie Meijer; Dewkoemar Ramsoekh; Gerd Bouma; Egbert-Jan van der Wouden; Bert den Hartog; Annemarie C de Vries; Frank Hoentjen; Gerard Dijkstra; Sybrand Y de Boer; Jeroen M Jansen; Andrea E van der Meulen; Ruud Beukers; Menno A Brink; Toos Steinhauser; Bas Oldenburg; Lennard P Gilissen; Ton H Naber; Marc A Verhagen; Nanne K H de Boer; Chris J J Mulder; Dutch Initiative on Crohn and Colitis (ICC)

doi:10.1016/j.cgh.2018.05.009

Clinical Course of Nodular Regenerative Hyperplasia in Thiopurine Treated Inflammatory Bowel Disease Patients

Clin Gastroenterol Hepatol. 2019 Feb;17(3):568-570. doi: 10.1016/j.cgh.2018.05.009. Epub 2018 Jun 1.

Authors

Melek Simsek¹, Berrie Meijer², Dewkoemar Ramsoekh², Gerd Bouma², Egbert-Jan van der Wouden³, Bert den Hartog⁴, Annemarie C de Vries⁵, Frank Hoentjen⁶, Gerard Dijkstra⁷, Sybrand Y de Boer⁸, Jeroen M Jansen⁹, Andrea E van der Meulen¹⁰, Ruud Beukers¹¹, Menno A Brink¹², Toos Steinhauser¹³, Bas Oldenburg¹⁴, Lennard P Gilissen¹⁵, Ton H Naber¹⁶, Marc A Verhagen¹⁷, Nanne K H de Boer², Chris J J Mulder²; Dutch Initiative on Crohn and Colitis (ICC)

Affiliations

¹ Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: m.simsek@vumc.nl.
² Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands.
³ Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands.
⁴ Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, The Netherlands.
⁵ Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁶ Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Gastroenterology and Hepatology, University Medical Center and University of Groningen, Groningen, The Netherlands.
⁸ Department of Gastroenterology and Hepatology, Slingeland Hospital, Doetinchem, The Netherlands.
⁹ Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
¹⁰ Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
¹¹ Department of Gastroenterology and Hepatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
¹² Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, The Netherlands.
¹³ Department of Gastroenterology and Hepatology, Bravis Hospital, Roosendaal, The Netherlands.
¹⁴ Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁵ Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands.
¹⁶ Department of Gastroenterology and Hepatology, Tergooi Hospital, Hilversum, The Netherlands.
¹⁷ Department of Gastroenterology and Hepatology, Diakonessen Hospital, Utrecht, The Netherlands.

PMID: 29775790
DOI: 10.1016/j.cgh.2018.05.009

Abstract

Nodular regenerative hyperplasia (NRH) is a poorly understood liver condition, which is increasingly recognized in thiopurine-treated patients with inflammatory bowel disease (IBD).¹ It is difficult to establish an optimal approach to NRH patients, because its manifestations are highly variable (from asymptomatic to symptoms of noncirrhotic portal hypertension [NCPH]) and the prognosis is unknown.² The aim of this study was to identify NRH cases in IBD patients treated with azathioprine, mercaptopurine, and/or thioguanine, and to describe its clinical course.

MeSH terms

Adolescent
Adult
Aged
Azathioprine / administration & dosage
Azathioprine / adverse effects*
Female
Humans
Hyperplasia / chemically induced
Hyperplasia / pathology*
Inflammatory Bowel Diseases / complications
Inflammatory Bowel Diseases / drug therapy*
Inflammatory Bowel Diseases / pathology*
Liver Diseases / pathology*
Male
Mercaptopurine / administration & dosage
Mercaptopurine / adverse effects*
Middle Aged
Thioguanine / administration & dosage
Thioguanine / adverse effects*
Young Adult

Substances

Mercaptopurine
Thioguanine
Azathioprine